Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 8;16(1):27.
doi: 10.1186/s13089-024-00357-6.

Veno-venous extracorporeal membrane oxygenation (VV ECMO) cannula malposition identified with point-of-care ultrasound

Taylor Becker  1 , Roger D Struble  2 , Charles Rappaport  2
Affiliations

Veno-venous extracorporeal membrane oxygenation (VV ECMO) cannula malposition identified with point-of-care ultrasound

Taylor Becker et al. Ultrasound J. .

Abstract

Background: Point-of-care ultrasound (POCUS) has become a mainstay in the evaluation of critically ill patients in the intensive care unit (ICU). ECMO patients are susceptible to complications during prolonged ICU stay, including cannula malposition, which has deleterious consequences. Although the literature surrounding utility of ultrasound on ECMO patients is expansive, direct comparison between radiographic imaging versus ultrasound for identification of cannula malposition is lacking.

Case presentation: The authors identified four patients with cannula malposition discovered through POCUS that was missed on routine radiographic imaging. Identification and correction of malposition changed their ECMO course.

Conclusion: This case series is the first in literature demonstrating that ultrasound may be superior to radiographic images for ECMO cannula malposition. Further investigation into this subject is warranted.

Keywords: Cannulation; ECMO; Point-of-care systems; Ultrasound.

PubMed Disclaimer

Conflict of interest statement

None reported.

Figures

Fig. 1
Fig. 1
Subcostal IVC view with the return jet positioned in the hepatic vein
Fig. 2
Fig. 2
Parasternal right ventricular (RV) inflow view showing the return jet appropriately positioned in the RV
See this image and copyright information in PMC

References

    1. Patroniti N, Pesenti A, Sangalli F. ECMO-extracorporeal life support in adults. 1. Milan: Springer; 2014.
    1. Hirose H, Yamane K, Marhefka G, Cavarocchi N. Right ventricular rupture and tamponade caused by malposition of the avalon cannula for venovenous extracorporeal membrane oxygenation. J Cardiothorac Surg. 2012;7:36. doi: 10.1186/1749-8090-7-36. - DOI - PMC - PubMed
    1. Winiszewski H, Perrotti A, Chocron S, Capellier G, Piton G. Malposition of the extracorporeal membrane oxygenation venous cannula in an accessory hepatic vein. J Extra Corpor Technol. 2018;50(3):167–169. doi: 10.1051/ject/201850167. - DOI - PMC - PubMed
    1. Yastrebov K, Kapalli T. Malposition of double lumen bicaval venovenous extracorporeal membrane oxygenation (VV ECMO) cannula resulting in hepatic venous congestion. Australas J Ultrasound Med. 2013;16(4):193–197. doi: 10.1002/j.2205-0140.2013.tb00247.x. - DOI - PMC - PubMed
    1. Victor K, Barrett NA, Gillon S, Gowland A, Meadows CI, Ioannou N. Critical care echo rounds: extracorporeal membrane oxygenation. Echo Res Pract. 2015;2(2):D1–D11. doi: 10.1530/ERP-14-0111. - DOI - PMC - PubMed

LinkOut - more resources