In Situ Venous Cannula Puncture: A Simplified Technique for Extracorporeal Membrane Oxygenation Blood Salvage

Salvaging residual circuit blood upon extracorporeal membrane oxygenation (ECMO) discontinuation is a clinically valuable blood conservation strategy, mirroring standard cardiopulmonary bypass protocols. We describe a simplified technique using an 8F vascular sheath inserted into the venous cannula via the Seldinger technique. Post-weaning, crystalloid infusion displaces 400-600 ml of sequestered autologous blood back to the patient at low pump speeds. This "off-the-shelf" method requires no prior circuit modification, maintains system integrity, and effectively reduces transfusion needs. It offers a safe, reproducible, and cost-effective approach for perioperative blood preservation in ECMO patients.