Pediatric Femoral Arterial Cannulations in Extracorporeal Membrane Oxygenation: A Review and Strategies for Optimization

Charles D. Fraser, Mark L. Kovler, William Guzman, Daniel Rhee, Ying Wei Lum, Samuel M. Alaish, Alejandro V. Garcia

Research output: Contribution to journalArticle

Abstract

Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is a treatment strategy for pediatric patients with cardiopulmonary failure. Femoral cannulation is a commonly used technique for obtaining central access in children and adolescents despite high rates of vascular complications. Ischemic limb complications remain one of the most common problems facing survivors of femoral VA ECMO. Our aim is to review the literature on femoral cannulation in children and to present a review of techniques for femoral cannula placement, decannulation, and arterial repair to help minimize and ameliorate complications related to cannulation. We performed a literature review for pediatric ECMO cannulation, complications, and femoral artery repair in pediatric patients. We focused on the management of arterial and ischemia-related complications during and after ECMO support via femoral cannulation. Vascular complications are not infrequent for patients requiring ECMO support via femoral cannulation. As such, judicious distal perfusion monitoring as well as augmentation of distal flow are important strategies during mechanical support. The use of distal perfusion catheters can be used to minimize the risk of limb ischemia. As femoral cannulation grows more popular in pediatric patients, strategies for arterial repair are essential to ensure extremity perfusion upon decannulation.

Original languageEnglish (US)
Pages (from-to)636-641
Number of pages6
JournalASAIO journal (American Society for Artificial Internal Organs : 1992)
Volume65
Issue number7
DOIs
StatePublished - Sep 1 2019

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Extracorporeal Membrane Oxygenation
Pediatrics
Oxygenation
Thigh
Catheterization
Membranes
Repair
Extremities
Perfusion
Blood Vessels
Catheters
Ischemia
Femoral Artery
Survivors
Monitoring

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Cite this

Pediatric Femoral Arterial Cannulations in Extracorporeal Membrane Oxygenation : A Review and Strategies for Optimization. / Fraser, Charles D.; Kovler, Mark L.; Guzman, William; Rhee, Daniel; Lum, Ying Wei; Alaish, Samuel M.; Garcia, Alejandro V.

In: ASAIO journal (American Society for Artificial Internal Organs : 1992), Vol. 65, No. 7, 01.09.2019, p. 636-641.

Research output: Contribution to journalArticle

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