ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1656101
This article is part of the Research TopicUltrasound in Cardiovascular Care: Preventive, Diagnostic, and Monitoring RolesView all 4 articles
Efficacy of Ultrasound Guided Venous Cannulation Positioning during Venous-Arterial Extracorporeal Membrane Oxygenation
Provisionally accepted
Yuanyuan Sun1Chengmin Huang2
Weimei Ou2Zhixian Liu2Guang Feng2Xinchen Zhang2Xu Chen1Bin Wang2
Guoming Zhang2*- 1Department of ultrasound, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Fujian Branch of National Clinical Research Center for Cardiovascular Diseases, Xiamen, China, Xiamen, China
- 2Emergency Department, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Fujian Branch of National Clinical Research Center for Cardiovascular Diseases, Xiamen, China, Xiamen, China
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Objective: To evaluate the clinical impact of ultrasound-guided venous cannulation positioning during the initiation of venous-arterial extracorporeal membrane oxygenation (VA-ECMO). Methods: This retrospective study included 48 patients who received bedside VA-ECMO support between June 2019 and August 2024. Patients were divided into an ultrasound-guided group (UG, n=23) and conventional body surface landmark group (BSL, n=25). Clinical outcomes, cannula positioning accuracy, complications, infection markers, and prognosis were compared. A subgroup analysis was performed in patients who did not undergo cardiopulmonary resuscitation (non-CPR). Results: Compared to BSL group, patients in the UG group had significantly higher rates of optimal venous cannula positioning (p < 0.01), lower incidence of unstable flow and pulmonary edema, and shorter aortic valve closure time, infection markers (WBC, PCT) were also significantly lower in the UG group (p < 0.05). In the non-CPR subgroup, the UG group had shorter ECMO duration, hospital stay, and dual antibiotic therapy duration (all p < 0.05), with non-significant trends toward better survival. Conclusion: Ultrasound-guided venous cannulation improves cannula positioning accuracy, reduces early complications, and may enhance clinical outcomes, particularly in non-CPR patients. Routine use of ultrasound guidance is thus recommended in bedside VA-ECMO procedures.
Keywords: ECMO, Ultrasound guidance, Venous cannulation, Hemodynamics, Infection
Received: 29 Jun 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Sun, Huang, Ou, Liu, Feng, Zhang, Chen, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Guoming Zhang, guomingheart@xmu.edu.cn
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