Bicaval Dual-Lumen ECMO Cannulation for Lung Transplantation

Use of the dual-lumen cannula (DLC) for veno-venous extracorporeal membrane oxygenation [(dl)V-V ECMO] has rapidly expanded in the adult population, particularly when used as a bridge to lung transplantation. This chapter begins with a case report of end-stage interstitial lung disease that resulted in (dl)V-V ECMO for a bridge to lung transplantation. The case is followed by clinical questions and answers highlighting the unique aspects, advantages, and pitfalls of (dl)V-V ECMO management. Increased knowledge and availability of ECMO have improved the likelihood of a positive outcome for refractory conditions, as in the case of end-stage interstitial lung disease patients. Careful patient selection is required in order to successfully bridge a patient to transplant and minimize the occurrence of fatal or debilitating complications.