Disclosures Definition Cannulation Strategy Cannulation Strategy
Disclosures Definition Cannulation Strategy Cannulation Strategy
Disclosures Definition Cannulation Strategy Cannulation Strategy
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Risks / Solutions - Venous<br />
• Venous Occlusion<br />
– Rare, but don’t occlude BOTH IJ’s<br />
– Anticoagulation probably helps<br />
• Recirculation (VV ECMO)<br />
– Drain from below, infuse into RA (IJ e.g.)<br />
• Venous “chatter”<br />
– RA or Intrahepatic IVC, NOT intra-abdominal<br />
• Occlusion - Accessory drainage?<br />
Special Circumstances<br />
• LV Venting (VA ECMO)<br />
– PV, LA appendage (open sternotomy)<br />
– LV apex (mini L Thoracotomy)<br />
– PA<br />
– Atrial septostomy<br />
• Femoral VA for respiratory Failure – VA-V<br />
• VA ECMO with<br />
Fem-Fem<br />
approach<br />
• Reasonable for<br />
Cardiac<br />
Resuscitation<br />
BUT<br />
• POOR for<br />
Respiratory<br />
Failure<br />
3/13/2012<br />
6
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