Best Practices for Vessel Management in Pediatric Extracorporeal Membrane Oxygenation Cannulation, Decannulation, and Follow-up: A Narrative Review

In brief

This narrative review examines best practices for vascular access management throughout the ECMO lifecycle in pediatric patients, from initial cannulation through decannulation and follow-up care. The authors synthesize evidence on cannula site selection, insertion techniques, and complication prevention strategies to guide interventionalists managing iatrogenic vascular injuries in this complex patient population.

• Vascular complications are common in pediatric ECMO despite preserved survival, requiring careful vessel management strategies.
• Cannula site selection and technique significantly impact iatrogenic vascular injury rates in neonatal and pediatric ECMO patients.
• Decannulation strategy choice affects long-term vascular outcomes and should be evidence-based for each patient population.
• Interventionalists need standardized approaches to prevent and manage ECMO-related vascular complications in children.
• Pediatric ECMO population complexity has increased since the 1970s, necessitating updated vessel management protocols.

Written by the GCMD Library team from the article.