*Extracorporeal Membrane Oxygenation (ECMO) Use in Heart Transplantation DOI: http://dx.doi.org/10.5772/intechopen.114126*

Biventricular) and/or combined respiratory and cardiac dysfunction failure who are refractory to optimal medical treatment. In these scenarios, ECMO is performed via a veno-arterial route. The venous drainage is from the right atrium which is usually accessed percutaneously through the femoral vein, however, the subclavian, jugular veins or a surgical central venous system may be used. Arterial cannulation can be either central/aortic or peripheral using the femoral, axillary, or subclavian artery. A recent systematic review and meta-analysis comparing central versus peripheral canulation for ECMO reports that central canulation is associated with greater hospital mortality, reoperation, and transfusion [9]. The peripheral arterial cannula range in size from 15 to 19 Fr. Central arterial cannulas are larger: up to 22 Fr. Adult-size venous cannulas used for drainage are often reinforced to avoid kinking, about 50 to 70 cm in length with a diameter of 19 to 25 FR. The presence of multiple side cannula holes along the end of the cannula facilitates drainage [10]. In pediatric patients, the sizes of the cannula are matched with the body surface area. This matching is critical to optimal delivery of support because the resistance to blood flow in the extracorporeal circuit is inversely proportional to the diameter of the return cannula [11]. Hence, optimal flows are facilitated by larger bore cannulas [12]. The ECMO circuit consists of a centrifugal pump; the oxygenator; the heat exchanger; the tubing of the circuit; the control console; the gas supply and blender; sensors and monitors; safety systems; and the power supply.
