Temporary extracorporeal life support using veno-arterial ECMO: Implementation techniques

Abstract

Peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) allows to secure patient’s hemodynamics and tissue perfusion. The most recommended route is the surgical canulation of the femoral artery and femoral vena using the Seldinger technique. Surgical implementation is rapid, can be performed under local anaesthetics, at the bedside, and even under cardiac massage. It allows safe cannulation of the vessels, good haemostasis, and reperfusion of the cannulated limb. ECMO implementation conditions further ECMO efficiency and possible onset of immediate as well as delayed life-threatening complications. ECMO implementation is not limited to cannula placement but requires surgical expertise to guarantee ECMO efficiency and simple postoperative course and facilitate further decannulation. Complications are numerous and can be even fatal, requiring management by trained teams available for emergent intervention and able to treat any ECMO complication.