Pilot Study of a Novel Gelatin-based Model for Venovenous Extracorporeal Membrane Oxygenation Cannula Insertion Simulation

• Type of Material: Article
• Authors: Richard Ramonell, Emory University; Caroline Coleman, Emory University; Ashley Binder, Emory University; Christina Creel, Emory University; Matthew D. Wiepking, University of Southern California; Michael Stentz, Emory University; Lisa Daniels, Emory University
• Language: English
• Date: 2021-09-01
• Publisher: American Thoracic Society
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the American Thoracic Society
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.34197/ats-scholar.2020-0167BR
• Title of Journal or Parent Work: ATS Scholar
• Volume: 2
• Issue: 3
• Start Page: 297
• End Page: 303
• Research Categories: Biology, Cell; Engineering, Biomedical

Abstract

Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a form of mechanical support used in respiratory failure refractory to conventional medical management. Because VV ECMO cannulation is an uncommonly performed, time-sensitive, and high-stakes procedure (1), simulation can be used to improve the procedural competency of trainees. Simulation-based training (SBT) has been shown to improve proficiency of vascular cannulation (2–5), yet there are few low-fidelity, low-cost, portable models that allow physicians-in-training to practice venous cannulation with an ECMO cannula. Most ECMO simulators are high-fidelity, software-based, interactive models (6–9). Because of the cost-prohibitive nature of such models, some nonhuman tissue models were developed for use in procedural skills laboratories for vascular access training, with promising improvements in procedural comfort and skill being shown (10). However, noncommercial simulators in the medical education literature are generally used to teach trainees management of intact ECMO circuits (11–13) or generally combine cannulation SBT with circuit management training (14, 15). Therefore, although these simulators may serve specific roles in ECMO SBT, they may not be as useful for the acquisition of skills related to venous cannula insertion. To address this educational need, we conducted an observational pilot study in which we developed a low-fidelity, low-cost, portable, gelatin-based model intended for use by trainees in preparation for VV ECMO initiation.