Introduction: Although decannulation from ECMO is usually irrevocable, in rare circumstances, ECMO will be reinitiated. Data on outcomes after re-cannulation of ECMO are limited,¹ so we studied our experience with ECMO re-cannulation within the same hospital visit.

Methods: We undertook a retrospective review of our prospectively collected database. All patients who were placed on ECMO more than once during the same hospital admission were included. Patients re-cannulated within 12 hours of decannulation were excluded. The primary outcome was survival.

Results: From 2010-2024, 510 adult patients were placed on ECMO at our institution, 293 veno-arterial (VA), 104 veno-venous (VV), 56 veno-pulmonary (VP), and 57 other/mix. A total of 8(1.6%) patients were placed on ECMO after decannulation (seven with 2 runs, and one with 3 runs total). Mean age was 51.1±18 years, and 6(75%) were male. Initially, 5 (63%) were cannulated VA, 1(13%) was cannulated VV and 2(25%) were VP. Their initial duration of support was 4±3 days. Regression of clinical status requiring ECMO re-cannulation occurred after 14±13 days. 2(29%) patients were placed back on VA ECMO, 1(14%) on VV, and 5(57%) on VP for 9 ± 8 additional days of support. Overall, 6/8(75%) survived to their final decannulation and 4(50%) survived to hospital discharge, as 3 patients died of sepsis and 1 patient died of cerebral hemorrhage.

Conclusion: Although rare, ECMO re-cannulation was able to salvage half of our cases in this study. However, further investigation is warranted.