{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:44:11Z","timestamp":1789515851097,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>\n                    Refractory hypoxemia during veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) may require an additional cannula (VV-V ECMO) to improve oxygenation. This intervention includes risk of recirculation and other various adverse events (AEs) such as injury to the lung, cannula malpositioning, bleeding, circuit or cannula thrombosis requiring intervention (i.e., clot), or cerebral injury. During the study period, 23 of 142 V-V ECMO patients were converted to VV-V utilizing two separate cannulas for bi-caval drainage with an additional upper extremity cannula placed for return. Of those, 21 had COVID-19. In the first 24\u00a0h after conversion, ECMO flow rates were higher (5.96 vs 5.24\u00a0L\/min,\n                    <jats:italic>p<\/jats:italic>\n                    = .002) with no significant change in pump speed (3764 vs 3630\u00a0revolutions per minute [RPMs],\n                    <jats:italic>p<\/jats:italic>\n                    = .42). Arterial oxygenation (PaO\n                    <jats:sub>2<\/jats:sub>\n                    ) increased (87 vs 64\u00a0mmHg,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; .0001) with comparable pre-oxygenator venous saturation (61 vs 53.3,\n                    <jats:italic>p<\/jats:italic>\n                    = .12). By day 5, flows were similar to pre-conversion values at lower pump speed but with improved PaO\n                    <jats:sub>2<\/jats:sub>\n                    . Unadjusted survival was similar in those converted to VV-V ECMO compared to V-V ECMO alone (70% [16\/23] vs 66.4% [79\/119],\n                    <jats:italic>p<\/jats:italic>\n                    = .77). In a mixed effect regression model, any incidence of AEs, demonstrated a negative impact on PaO\n                    <jats:sub>2<\/jats:sub>\n                    in the first 48\u00a0h but not at day 5. VV-V ECMO improved oxygenation with increasing flows without a significant difference in AEs or pump speed. AEs transiently impacted oxygenation. VV-V ECMO is effective and feasible strategy for refractory hypoxemia on VV-ECMO allowing for higher flow rate and unchanged pump speed.\n                  <\/jats:p>","DOI":"10.1177\/02676591241249609","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T03:09:16Z","timestamp":1715915356000},"page":"647-656","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Outcomes following additional drainage during veno-venous extracorporeal membrane oxygenation: A single-center retrospective study"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8859-6491","authenticated-orcid":false,"given":"Sagar B","family":"Dave","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Emory Critical Care Center, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Leiendecker","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Emory Critical Care Center, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Creel-Bulos","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Emory Critical Care Center, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1286-5581","authenticated-orcid":false,"given":"Casey Frost","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W","family":"Boorman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2070-0528","authenticated-orcid":false,"given":"Jeffrey","family":"Javidfar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamer","family":"Attia","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mani","family":"Daneshmand","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6687-3953","authenticated-orcid":false,"given":"Craig S","family":"Jabaley","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Emory Critical Care Center, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Caridi-Schieble","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Emory Critical Care Center, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,17]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4996-5"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005372"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.4.1347"},{"issue":"5","key":"e_1_3_5_5_2","first-page":"314","article-title":"Lung recruitment during ARDS","volume":"66","author":"Marini JJ","year":"2000","unstructured":"Marini JJ, Amato MB. Lung recruitment during ARDS. Minerva Anestesiol 2000; 66(5): 314\u2013319.","journal-title":"Minerva Anestesiol"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4273-z"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002870"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61069-2"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.09.031"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2017.06.58"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.21470\/1678-9741-2020-0397"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.04.81"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.12.88"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.03.84"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjtc.2021.08.048"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0026-4725.20.05328-1"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10071-24054"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/membranes11060434"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201311-2023OC"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1888-6"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/02676591221078694"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40635-022-00434-x"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e318292dd10"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2785-8"},{"key":"e_1_3_5_26_2","unstructured":"ELSO guidelines for cardiopulmonary extracorporeal life support. Version 1.4. Available at: https:\/\/www.elsonet.org. accessed on 29 January 2021."},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002643"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000179"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2000.16402"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000440"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.160.55"},{"key":"e_1_3_5_32_2","volume-title":"StatPearls","author":"Chetana Shanmukhappa S","year":"2022","unstructured":"Chetana Shanmukhappa S, Lokeshwaran S: Venous oxygen saturation. In: StatPearls. edn. Island (FL): Treasure; 2022."},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4318-3"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06593-x"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/02676591211035938"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591241249609","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591241249609","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591241249609","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:34:37Z","timestamp":1777656877000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591241249609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,17]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/02676591241249609"],"URL":"https:\/\/doi.org\/10.1177\/02676591241249609","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,17]]}}}