ECMO

General Concepts

Cannulation


Double Lumen Venous Cannula

Figure 1: Example of Double Lumen Veno-Venous (VV) Cannula -Avalon


Crescent Cannula Positioning and Radio-opacity


Figure 2: Example of VA ECMO Circuit


Figure 3: VV ECMO Circuit Components Schematic (From University of Iowa)


Figure 4: ECMO Circuit Components


Parts of the ECMO Circuit

Anticoagulation on ECMO

Courtesy of Richard Pierce, MD

Patient Selection

VV ECMO

VA ECMO

ECPR

Complications

Evidence

Troubleshooting

    Insufficient Flow

    Hypoxemia

    Hypotension

    Bleeding

References

1. Paden ML, Conrad SA, Rycus PT, Thiagarajan RR; ELSO Registry. ExtracorporealLife Support Organization Registry Report 2012. ASAIO J. 2013

2. Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, HibbertCL, Truesdale A, Clemens F, Cooper N, Firmin RK, Elbourne D; CESAR trial collaboration. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet. 2009 Oct 17;374(9698):1351-63.

3. Stanford ECMO Clinical Guidelines (internal)

4. ECMO iBook Resource (Peggy Han, MD)