Cannulation

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jordansparks
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Joined: Thu Aug 27, 2015 3:59 pm

Cannulation

Postby jordansparks » Wed Mar 08, 2017 10:44 am

Cannulation refers to the surgical procedure of inserting a cannula (tube) into a major artery. This then allows various solutions and chemicals to be perfused (pumped) into the circulatory system. Cannulation remains our most urgent unsolved problem. We've spent years working on this problem, and it's still not solved to my satisfaction. Scientifically, the best approach would be to perform the surgery while the patient is still alive. This is done routinely on animals in laboratory settings, but we do not have this option on humans yet. So all remaining options are compromises of one sort or another.
We continue to make progress each week on new techniques, new instruments, new equipment, etc. For example:
http://www.oregoncryo.com/manual/cannulae.html
I feel like we are only about a month or two away from having an extremely reliable and fast technique. Of course, even after we reach that point, there will be plenty more improvements that we can make. Refining the procedure will take a few more years of work. For example, there is a particular custom surgical instrument that I've wanted to build for years, and which I think we will build some day. It would look like small forceps, but with a ring clamp on the end to hold a cannula within a carotid. We already employ a variety of techniques for this task, including a suture snare, a Javid carotid artery clamp, and a Tofflemire matrix band retainer. But a custom instrument could be faster and more reliable.

jordansparks
Site Admin
Posts: 37
Joined: Thu Aug 27, 2015 3:59 pm

Re: Cannulation

Postby jordansparks » Wed Apr 12, 2017 9:39 am

Done!

After years of work, we finally have a safe, reliable, and tested cannulation procedure.
http://www.oregoncryo.com/manual/surgicalProcedures.html
It currently takes about 8 minutes from start to finish for cannulation of the first carotid artery and beginning of washout. It should easily be possible to reduce that time to under 5 minutes with practice. This speed should be achievable on a routine basis, regardless of the situation.

Unfortunately, there will usually also be a period of time between pronouncement and when we are allowed to begin cannulation. If the procedure is not performed in our facility, then it might typically take from 5 to 20 minutes to move the patient out to the vehicle and start cannulation. During this time, the head will be cooled in an ice bath with nasopharyngeal irrigation.

jordansparks
Site Admin
Posts: 37
Joined: Thu Aug 27, 2015 3:59 pm

Re: Cannulation

Postby jordansparks » Tue Jul 25, 2017 4:32 pm

We are now down to under two minutes.

jordansparks
Site Admin
Posts: 37
Joined: Thu Aug 27, 2015 3:59 pm

Re: Cannulation

Postby jordansparks » Fri Aug 18, 2017 9:33 am

Under one minute, now, with a clear path to achieve 30 seconds before too much longer. Just need to fabricate the newly-designed cannula.


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