New Treatment Option for Respiratory Distress and Heart Failure

An innovative cannula provides venous drainage and reinfusion via an internal jugular vein during acute respiratory distress syndrome (ARDS) extracorporeal life support procedures.

The Protek Duo cannula is intended for use in veno-venous extracorporeal life support (VV ECLS), an emerging therapy designed to infuse oxygen directly into the blood using an oxygenator that acts as an artificial lung. The tapered cannula is inserted using and introducer via a percutaneous procedure, following which it provides omnidirectional flow, bypassing the right ventricle and directing blood flow from the right atrium to the pulmonary artery, this optimizing gas exchange and simultaneously reducing stress on the right side of the heart.

Key features include a friction fit introducer and hemostasis cap to minimize blood loss during insertion; a coaxial wire-wound design for kink resistant inner (16 Fr) and out (29 Fr) lumens; omnidirectional flow ports for consistent performance without repositioning; and radiopaque disks for better visualization under fluoroscopy. Patient management is simplified by combining the Protek Duo cannula with the lightweight TandemHeart pump, which can be placed directly on the patient. The Protek Duo cannula is a product of CardiacAssist (Pittsburgh, PA, USA), and has been approved by the US Food and Drug Administration (FDA).

“The percutaneous internal jugular approach of this promising new technology will give us the ability to minimize the morbidity usually associated with central extracorporeal life support cannulation,” said Jose Garcia, MD, director of cardiothoracic transplantation at Massachusetts General Hospital (Boston, MA, USA). “By optimizing patient mobility, we also expect to reduce the long-term negative effects of severe deconditioning. The extracorporeal life support community welcomes these innovative medical devices designed to help physicians improve patient outcomes.”

ARDS is a disease of the alveoli of the lungs that leads to decreased exchange of oxygen and carbon dioxide (CO2). It is associated with several pathologic changes, including the release of inflammatory chemicals, breakdown of the cells lining the lung's blood vessels, surfactant loss leading to increased surface tension in the lung, fluid accumulation in the lung, and excessive fibrous connective tissue formation. The condition affects an estimated 2.2 million people worldwide each year, and has a high mortality rate of 20%–50%.

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