[Cannulation related complications and prevention for extracorporeal membrane oxygenation: clinical report and reviews of experience of 34 cases].

Objective: To review the cannulation strategies and associated vascular complications of extracorporeal membrane oxygenation (ECMO) and to investigate the etiology and preventive procedures for those complications.

Methods: From January 2007 to December 2011, 34 patients (21 male and 13 female patients, aged from 23 to 66 years) underwent ECMO support through open approach, semi-Seldinger method or full Seldinger method of cannulation. Bleeding and limb ischemia related to the approach as major complications were retrospectively analyzed.

Results: The ECMO duration were 2 to 21 days. Twenty-four patients (70.6%) successfully weaned from ECMO and 18 patients (52.9%) discharged. The venoarterial mode was used in 26 patients, and venovenous mode in 8 patients. Eight patients (30.8%, 6 for open approach and 2 for semi-seldinger) observed with limb ischemia, 2 of them required amputation, 1 had claudicatory sequela. Eleven and 6 patients suffered from bleeding and vessel injury respectively, all of them recovered by suitable treatment.

Conclusions: The proper size of cannula, optimal approch and position adjustment, accurate cannula placement and carefully attendance are the key points to decrease the cannulation related complications.