Dermabond as a Novel Solution for Needle-Hole Repair in Arterial Cannula while on Extracorporeal Membrane Oxygenation Therapy

Abstract

The annual incidence of extracorporeal membrane oxygenation (ECMO) for adult patients is increasing. Indications may vary from acute lung injury, ECMO-assisted cardiopulmonary resuscitation, to cardiac failure with an inability to wean from cardiopulmonary bypass. Complications may happen to the ECMO circuit, including cannula leaks from holes, cracks, or other damage, during the support period. Here, we present a novel solution for repairing a bleeding structural leak in the side of an arterial cannula. Dermabond was used to seal a small leak in the cannula likely caused by an earlier accidental needle puncture. Dermabond was applied to the area of damage, then allowed to cure, and wrapped with Ioban for increased stability. The patient was weaned from ECMO 2 days later without any complications from the repair of the cannula. The cannula was unable to be exchanged because of the small thoracotomy used to gain access for cannulation, so a repair was attempted. Moving the cannula to the femoral vessel was ruled out because of continued hypoxia and fear of creating a mixing cloud. Although less invasive incisions are becoming more common in cardiac surgery, these incisions for ECMO may be problematic if issues related to cannulas arise.