In Situ Venous Cannula Puncture: A Simplified Technique for Extracorporeal Membrane Oxygenation Blood Salvage
Abstract
Salvaging residual circuit blood upon extracorporeal membrane oxygenation (ECMO) discontinuation is a clinically valuable blood conservation strategy, mirroring standard cardiopulmonary bypass protocols. We describe a simplified technique using an 8F vascular sheath inserted into the venous cannula via the Seldinger technique. Post-weaning, crystalloid infusion displaces 400–600 ml of sequestered autologous blood back to the patient at low pump speeds. This “off-the-shelf” method requires no prior circuit modification, maintains system integrity, and effectively reduces transfusion needs. It offers a safe, reproducible, and cost-effective approach for perioperative blood preservation in ECMO patients.
Following extracorporeal membrane oxygenation (ECMO) weaning, 400–600 ml of autologous blood may remain within the circuit. Current management strategies are limited by blood loss, procedural complexity, cost, or safety concerns, and many reported salvage techniques require circuit modification before ECMO initiation. We present a simple technique using standard vascular access equipment to facilitate residual ECMO blood reinfusion without prior circuit modification, offering a practical approach to perioperative blood conservation.