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Updated: Dec 25, 2025

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
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Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting

Published on: January 17, 2025

685

A multidisciplinary approach to VA ECMO cannulation in children

Emile I Gleeson1, Megan E Cunningham2, Cole Burgman2

  • 1Baylor College of Medicine, School of Medicine, Houston, TX.

Journal of Pediatric Surgery
|April 3, 2020
PubMed

Insights

A collaborative pediatric surgery and interventional radiology approach to peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) cannulation is safe and feasible. This method ensures limb perfusion, potentially improving outcomes for critically ill children.

Area of Science:

  • Pediatric critical care medicine
  • Interventional cardiology
  • Pediatric surgery

Background:

  • Extracorporeal membrane oxygenation (ECMO) is vital for supporting gas exchange and circulation in critically ill patients.
  • A multidisciplinary approach integrating pediatric surgery (PS) and interventional radiology (IR) can optimize ECMO cannulation procedures.

Purpose of the Study:

  • To describe a collaborative, multidisciplinary strategy for peripheral veno-arterial (VA) ECMO cannulation in pediatric patients.
  • To evaluate the feasibility and safety of this combined PS and IR approach.

Main Methods:

  • A case series of pediatric patients (<18 years) undergoing percutaneous cannulation for peripheral VA ECMO by PS and IR.
  • Exclusion criteria included cardiac patients and those cannulated by PS alone.
  • Focus on the placement of arterial and venous catheters and antegrade distal perfusion cannulas (DPC).

Main Results:

  • Five pediatric patients were included, with a median age of 16 years.
  • Catheter sizes averaged 19 Fr (arterial) and 25 Fr (venous), placed in common femoral vessels.
  • Two bleeding episodes occurred; no limb circulation loss was reported. Distal perfusion cannulas were successfully placed and removed.

Conclusions:

  • The multidisciplinary PS and IR approach to peripheral VA ECMO cannulation is demonstrated as feasible and safe.
  • Percutaneous placement and removal of distal perfusion cannulas (DPC) represent a key advantage, potentially maintaining limb perfusion.
Abstract

Keywords:
CannulationECMOExtracorporeal life supportInterventional radiologyMultidisciplinaryPediatric surgery

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