Survey of the American Pediatric Surgical Association on cannulation practices in pediatric ECMO
Topic overview
APSA survey of 252 pediatric surgeons reveals significant practice variation in ECMO cannulation strategies, particularly for school-age children. Key findings include 28% using neck vessels exclusively, variable approaches to carotid repair post-decannulation, and age-dependent preferences for femoral access with distal perfusion being the primary technical challenge.
Key takeaways
- 28% of pediatric surgeons use neck vessels exclusively for ECMO cannulation regardless of patient age or weight.
- Only 6.6% routinely repair carotid artery after neck decannulation; 10.7% repair selectively for children over 5 years.
- Distal perfusion management is the most common challenge in femoral cannulation (60%), often requiring vascular surgery consultation.
- Surgeons with <10 years experience consult vascular surgery more frequently than experienced surgeons (18.5% vs 8%).
- Significant practice variation exists in pediatric ECMO cannulation, particularly for school-age and adolescent patients.
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