Veno-Venous ECMO Initiation

Veno-venous ECMO use is increasing at many centres.  Seldom an elective procedure and typically done on patients too sick to transport, bedside guidance of ECMO cannula insertion is essential.

As this tutorial (by Dr. Vince Lau) highlights, point-of-care TEE can be invaluable in these circumstances in providing real time guidance of guidewire and cannula positioning.  Further, adjustments of the cannula’s outflow port can be done using color Doppler to optimize the yield of the intervention.