Vascular Access for Extracorporeal Membrane Oxygenation

Reliable and safe vascular access is a key foundation for successful extracorporeal therapy. In addition to the use of standardized techniques for vascular access, identifying the appropriate cannulation strategy for a given patient’s pathophysiology should be determined. Extracorporeal membrane oxygenation (ECMO) comes in two forms: veno-arterial (VA) and veno-venous (VV) ECMO. VA-ECMO utilizes a venous drainage, from into a large vein or right atrium, and arterial return, typically a large artery. VV-ECMO, on the other hand, returns oxygenated blood to the right atrium, for passage through the disease lungs. Unloading of the left ventricle has been shown to be associated with improved outcomes in patients requiring temporary mechanical support.