What are the most commonly used cannulation sites for VV ECMO?

The most commonly used cannulation sites for venovenous (VV) ECMO are the right internal jugular vein and the femoral vein. This is primarily due to the anatomical positioning and accessibility of these veins, which allows for effective venous drainage and reinfusion.

The right internal jugular vein offers an excellent route for drainage of deoxygenated blood from the central venous system, facilitating efficient support for the patient’s pulmonary circulation. In conjunction with the femoral vein, which serves as the reinfusion site for oxygenated blood, this dual-site configuration optimizes the flow dynamics needed for effective ECMO therapy.

Additionally, the right internal jugular vein is preferred because it is centrally located and has a large diameter, making it suitable for the insertion of large-bore cannulas required for effective blood flow rates in VV ECMO. The femoral vein complements this setup by providing a position that is relatively easy to access, even in critically ill patients, which enhances the feasibility of the procedure.

This configuration is commonly employed in clinical practice, which reinforces its status as the preferred approach for VV ECMO interventions. Other potential sites, like subclavian or brachial veins, may have limited blood flow capacity or accessibility challenges that make