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

METHODSFrom 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.

RESULTSThe 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.

CONCLUSIONSThe 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.