EPISODE · Feb 20, 2018 · 29 MIN
EDECMO 43: The Cutdown
from ED ECMO · host Zack Shinar, MD
In this episode, Alice Hutin of the Paris SAMU talks about the modified cutdown approach to cannula insertion. She is an emergency physician who is one of four physicians who take call on the pre-hospital ECMO ambulance. She describes the process of their modified cutdown. First, incision through the skin is made 2 cm below inguinal crease. Second, blunt dissection down through the soft tissue. This is best done with your fingers. Third, place a needle through the distal skin and visualize it pass into the vessel. From there, you cannulate as with percutaneous. Alice’s recent paper shows a 6% failure rate with this technique in skilled hands.
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The Cutdown Approach to ECMO Cannula Insertion with Alice Hutin, Lionel Lamhaut, and Zack Shinar In this episode, Alice Hutin of the Paris SAMU talks about the modified cutdown approach to cannula insertion. She is an emergency physician who is one of four physicians who cannulates on the pre-hospital ECMO ambulance. She describes the process of their modified cutdown. We are holding off on written descriptions and pictures of the procedure pending Alice's publication so you will just have to listen!!!! We'll post the pictures soon! Until then, here is a youtube segment showing a femoral cutdown -https://www.youtube.com/watch?v=zzu7cU3YoXo Another recent publication by Alice: Hutin A, Lamhaut L, Lidouren F, Kohlhauer M, Mongardon N, Carli P, Berdeaux A, Ghaleh B, Tissier R. Early Coronary Reperfusion Facilitates Return of Spontaneous Circulation and Improves Cardiovascular Outcomes After Ischemic Cardiac Arrest and Extracorporeal Resuscitation in Pigs. J Am Heart Assoc. 2016 Dec 22;5(12). pii: e004588. doi: 1. PubMed PMID: 28007740; PubMed Central PMCID: PMC5210433 References 1. Hutin A, Lamhaut L, Lidouren F, et al. Early Coronary Reperfusion Facilitates Return of Spontaneous Circulation and Improves Cardiovascular Outcomes After Ischemic Cardiac Arrest and Extracorporeal Resuscitation in Pigs. J. 2016;5(12):e004588. doi: 10.1161/jaha.116.004588
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EDECMO 43: The Cutdown
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