In a recent ICN post, we provided an introduction to extra-corporeal membrane oxygenation (ECMO). In this post, Dr Roger Pye demonstrates everything you need to know about the Avalon Cannula. This piece of equipment is an amazing double lumen ecmo canula that enables the entire V-V ECMO circuit to run through the one site via the right internal jugular vein. With one lumen sited in both the IVC and SVC for retrieving venous blood, and one lumen with a delivery port sited in the right atrium, it enables deoxygenated blood to be retrieved to the filter and then oxygenated blood to be returned to the blood to the heart with minimal recirculation. This set up is particularly useful in patients that require retrieval or transport, including long haul transports, however it can be used for extended periods in hospital.
It is inserted using the Seldinger technique and as you will see, in order to minimise risk of potentially fatal complications of insertion, TOE visualisation of the wire, then cannula passing through the SVC into the RA then into the IVC is essential. During this highly entertaining presentation, Dr Roger Pye describes the (almost) one person technique for insertion of the Avalon Cannula including a step-by-step interactive illustration. Many of the slides used can be seen in higher resolution here.
The ability to insert these cannulas in smaller centres to enable transfer to larger ECMO competent centres can be the difference between life and death for some patients. Well worth a watch!!
For more information on ECMO – check out EdECMO!