Abstract
For rapid and safe extracorporeal cardiopulmonary resuscitation (ECPR) induction without using a fluoroscope, we cannulated the right internal jugular vein for outflow in out-of-hospital cardiac arrest patients. Four patients underwent ECPR (average time from arrival to initiation of extracorporeal membrane oxygenation (ECMO) [minimum-maximum], 19.5 min [16-23 min]; and ECMO pump flow, 2.5 l/min [1.2-3.7 l/min]). There were no complications associated with ECMO induction (massive bleeding, ischemia, infection, or misplacement). Sufficient ECMO pump flow was obtained before return of spontaneous circulation (ROSC). We relocated the blood outflow cannula site to the femoral vein in one patient due to a low flow rate after ROSC. Two out of four patients were weaned from ECMO. One patient survived without a neurologic deficit; the other three patients died. Right internal jugular vein cannulation (outflow) provided rapid and safe induction of ECPR in out-of-hospital cardiac arrest patients when a fluoroscope was not available. However, there was some limitation in the flow rate after ROSC.
