EDECMO 43: The Cutdown

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

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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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tom fiero

truly an incredible podcast. inspiring, and beautifully, clearly described. i met lionel and alice at reanimate 3, and am now re-inspired. i wonder if they do their REBOA via cut-down as well. it seems the advantage of the cut-down, if one doesn’t make a bloody mess of it, its that it is all there in the open. and there is less need for 3-4 dilators because you have bluntly dissected all the connective tissue and overlying layers off the vessels. and the fem artery/vein are in your fingers. as well as other advantages mentioned. would live to see the upcoming… Read more »