Are there different types of ECMO?
Yes. There are two different ways for ECMO to support a patient. The first method is called veno-arterial or VA ECMO. VA ECMO will support the heart and lungs. This requires two cannulas (large plastic tubes, also called catheters) - one in a large vein and one in a large artery. We surgically place the cannula through the right side of the neck or directly through an incision in the chest if the patient has had cardiac surgery. The second method is called veno-venous or VV ECMO. This is used for lung support only. With this type of ECMO, we often place only one cannula through the right side of the neck. Sometimes, in larger patients, we must place two cannulas, one in the neck and one in the groin. Once we use the artery or vein for ECMO, we will tie it off (ligate) except in special circumstances. The patient should develop a back-up system (called collateral circulation) for blood flow on that side. We will always try to use VV ECMO if possible (no heart support needed) so that we do not have to tie off the carotid artery. We have recently started placing the VV cannulas without a surgical incision. This method is called "percutaneous cannulation". When the patient is ready to have the cannula removed we pull it like an IV and hold pressure for 20 minutes. With this type of cannula placement, we do not tie off the veins. We use this method ONLY for venovenous ECMO.