**7. Complications of ECPR**

ECPR, like other forms of ECLS, is used as a potential lifesaving approach. But it has the potential for adverse consequences ranging from minor to fatal complications. Observational studies show that 1 in 4 patients ends up having complications [59]. Complications include limb ischemia, vascular damage leading to inability to the cannulate the vessel or profound intracorporeal or extracorporeal bleeding, tamponade, failure to maintain adequate ECMO flow resulting in inadequate support, and intracranial hemorrhage with grave consequences and dismal survival. Other issues such as multiple organ failure, sepsis, and hypoxic brain injury (cerebral stroke or cerebral stroke and hemorrhage, coma, diffuse anoxic brain injury, and brain death) can also occur in the absence of adequate perfusion of the organs with oxygenated blood [50, 60].
