title: [Cannulation related complications and prevention for extracorporeal membrane oxygenation: clinical report and reviews of experience of 34 cases].
abstract: 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.
authors: Department of Cardiopulmonary Bypass, Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200030, China.
authors: Zhen
authors: Z
authors: Guo
authors: Department of Cardiopulmonary Bypass, Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200030, China. Email:guozhen76@gmail.com.
authors: Xin
authors: X
authors: Li
authors: Department of Cardiopulmonary Bypass, Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200030, China.
authors: Ling-Feng
authors: LF
authors: Xu
authors: Department of Cardiopulmonary Bypass, Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200030, China.
authors: Xin
authors: X
authors: Chang
mesh_terms: D000671:Amputation, Surgical; D002406:Catheterization, Peripheral; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D007511:Ischemia; D012189:Retrospective Studies