Page 6 - Virtual Vascular Vol 2 Sep 2020-f
P. 6

Extracorporeal Membrane



         Oxygenation (ECMO)












      •    ECMO is a life-saving technique to manage refractory cardiopulmonary
           failure




      •    In veno-arterial (VA) ECMO, the venous cannula is placed in the common
           femoral vein with the tip of the venous cannula near the junction of the

           inferior vena cava and right atrium for extraction of blood for artificial

           oxygenation and removal of carbon dioxide                                                                                                                                            Arterial                        Venous

                                                                                                                                                                                                cannula                         cannula
      •    The blood is then returned to the patient via the arterial cannula placed

           in the femoral artery with the tip in the iliac artery or aorta



      •    Peripheral ECMO via the femoral vessels is simpler, but  central VA ECMO

           can also be used if cardiopulmonary bypass has already been established
           or emergency re-sternotomy has been performed, with the venous

           cannula in the right atrium or vena cavae, and arterial cannula in the

           ascending aorta).



      •    The circuit needs to be anticoagulated with heparin






                                                                                                                              A patient in ICU on veno-arterial ECMO with the cannulae in the right femoral vein

                                                                                                                              and artery.

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