Pediatric arterial femoral cannulations for extracorporeal membrane oxygenation: Does size really matter?

Retrospective ELSO database study (2012-2017) of 429 pediatric patients demonstrating that smaller femoral arterial cannulas (15-16Fr) achieve equivalent pump flows to larger sizes while reducing limb ischemia risk. Cannulas ≥21Fr showed 4.38-fold increased ischemia risk compared to 15-16Fr without flow advantage.