VV ECMO cannulation in infants and children under 10 kg: Evolving strategies, outcomes, and innovations.

[en] Venovenous extracorporeal membrane oxygenation (VV ECMO) has become an increasingly preferred modality for respiratory support in neonates and infants under 10 kg, driven by a growing recognition of its neurological safety advantages over venoarterial (VA) ECMO. Historically, VV ECMO was limited in this population due to small vessel size, anatomical constraints, and technical challenges in achieving stable high-flow access. Recent advancements, including the development of the Crescent Right-Atrial (RA) dual-lumen cannula and increasing adoption of multisite cannulation strategies, have significantly expanded VV ECMO feasibility in neonates and small infants. Institutional experiences now support the safety and efficacy of VV ECMO in this vulnerable group when performed with skilled teams and advanced imaging guidance. This review synthesizes current evidence, highlights evolving cannulation techniques, and presents innovative solutions aimed at improving outcomes for infants and children under 10 kg requiring VV ECMO.

Disciplines :

Anesthesia & intensive care

Author, co-author :

Assy, Jana ; Université de Liège - ULiège > Département des sciences cliniques > Médecine générale

El Rassi, Issam ; Pediatric Cardiac Surgery, Al Jalila Children's Hospital, Dubai

Language :

English

Title :

VV ECMO cannulation in infants and children under 10 kg: Evolving strategies, outcomes, and innovations.

Publication date :

11 September 2025

Journal title :

Perfusion

ISSN :

0267-6591

eISSN :

1477-111X

Publisher :

SAGE Publications Ltd, England

Pages :

2676591251379622

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://journals.sagepub.com/doi/pdf/10.1177/02676591251379622

Available on ORBi :

since 19 March 2026

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