Series of case report: Left - sided cannulation in paediatric patient on VV ECMO

IntroductionThis article presents our experience with an alternative cannulation strategy for VV ECMO, adding it to previously reported cases found on PubMed.Case reportWe report three cases: two patients aged 17 and one aged 3. Two required VV ECMO for pneumonia, and one for airway surgery. All patients had a two-site approach. In two cases, drainage was initiated from the left side of the neck at the onset of therapy, with return to the groin. One patient required a change in the drainage cannula from the right to the left side during treatment, while the return continued to the groin.DiscussionMany centres have reported positive outcomes with alternative sites for cannulation in adults, including the left side of the neck. Alternative sites for cannulation require proper visualization techniques for guidewire and cannula insertion due to possible complications. We share our positive experience with left-sided cannulation using transthoracic echocardiographic visualization and a supraclavicular approach in paediatric patients of various weights.ConclusionLeft-sided cannulation is a safe option in specific clinical cases. Further studies are needed to validate this approach, especially for paediatric patients.