Feasibility of Smaller Arterial Cannulas in Veno-arterial Extracorporeal Membrane Oxygenation

The Columbia University group performed this retrospective review of femoral VA ECMO at their institution from 2007-2013, and analyzed short-term outcomes based on the size of the arterial cannula.  They compared two groups of patients:  those undergoing femoral cannulation with a size 17F or larger cannula versus those undergoing cannulation with a 15F cannula. Despite higher flows in the larger cannula group, at 24 hours of support there were no differences in hemodynamic or laboratory parameters or in the use of vasoactive medications.  There was also no difference in 30-day survival.  Importantly, however, there was a significant reduction in bleeding complications in the group receiving the smaller arterial cannula.