Central venous catheter placement during extracorporeal membrane oxygenation therapy

Abstract Extra-Corporeal Membrane Oxygenation (ECMO) has become increasingly used for rescue therapy of severe cardiac or/and respiratory failures. If a central venous catheter is mandatory for managing these critically ill patients, its insertion during emergent ECMO implantation exposes to unique mechanical complications. We report the case of ECMO implementation for refractory cardiac arrest, complicated with guidewire suctioning into ECMO circuit. Through the analysis of this guidewire embolism, we propose to discuss some technical points regarding the ideal time and site of insertion as well as precautions that should be assessed before inserting the central venous catheter in patients treated with ECMO, in order to limit the potential life-threatening complications.