Bedside cannulation for veno-venous extracorporeal membrane oxygenation using portable X-ray system in a coronavirus disease patient

Kondo, Toru; Kuwayama, Tasuku; Hiraiwa, Hiroaki; Kasugai, Daisuke; Goto, Yukari; Numaguchi, Atsushi; Katsu, Toshihiko; Matsui, Toshinori; Hashimoto, Naozumi; Tanaka, Akihito; Morimoto, Ryota; Okumura, Takahiro; Murohara, Toyoaki

Transportation of patients with coronavirus disease (COVID)-19 outside isolation rooms should be avoided to prevent further spread of the disease. Here, we report a safe and accurate bedside cannulation method for veno-venous extracorporeal membrane oxygenation (VV-ECMO) in a COVID-19 patient in the intensive care unit. A 71-year-old man was admitted to our hospital and diagnosed as having COVID-19 pneumonia. We decided to initiate VV-ECMO therapy because maintaining blood oxygen saturation was difficult despite the mechanical ventilation. We placed two flat-panel detectors behind the patient's chest and the right inguinal area. We repeatedly imaged and monitored insertion of wires and cannulas using a portable X-ray system. Cannulas were successfully inserted in the appropriate position, and VV-ECMO was initiated without any complications.