Akademik Veri Yönetim Sistemi
Anestezi Dergisi, cilt.33, sa.1, ss.1-10, 2025 (Scopus)
Extracorporeal Membrane Oxygenation (ECMO) has become an increasingly utilized advanced support method in recent years for life-threatening cardiopulmonary failure. One of the most critical steps that directly impacts the effectiveness and safety of ECMO is the cannulation procedure. This process varies depending on the modality, whether veno-venous or veno-arterial ECMO, and selecting the appropriate cannulation strategy must align with the patient's physiology and pathology. Cannulation is typically performed using percutaneous techniques under ultrasound and fluoroscopic guidance. However, surgical methods are also employed, particularly in pediatric patients or cases with anatomical abnormalities. Failure or complications during cannulation can lead to severe issues, including hemodynamic instability, bleeding, thrombosis, and vascular injury. Therefore, it is crucial that the procedure is conducted by an experienced team. Recent advancements in technology, improvements in cannula designs, and innovations in imaging guidance have significantly enhanced the safety of cannulation. Nonetheless, the procedure continues to pose substantial challenges in pediatric and neonatal patients, emphasizing the need for more specific guidelines for these vulnerable groups. This review aims to highlight current approaches and complication management strategies in ECMO cannulation, providing clinicians with guidance on performing this critical procedure. Adhering to standardized protocols and involving well-trained teams in the process play a pivotal role in improving the success of ECMO.