the cannula is most commonly placed in the myocardium for cardiopulmonary bypass procedures.
the cannula is most commonly placed in the myocardium for cardiopulmonary bypass procedures.
where are the cannula most commonly placed for cardiopulmonary bypass procedures?
the myocardium
in veno-arterial (va) ecmo, a venous cannula is usually placed in the right or left common femoral vein for extraction, and an arterial cannula is usually placed into the right or left femoral artery for infusion. the tip of the femoral venous cannula should be maintained near the junction of the inferior vena cava and right atrium, while the tip of the femoral arterial cannula is maintained in the iliac artery. in adults, accessing the femoral artery is preferred because the insertion is simpler. central va ecmo may be used if cardiopulmonary bypass has already been established or emergency re-sternotomy has been performed (with cannulae in the right atrium(or svc/ivc for tricuspid repair) and ascending aorta).
extracorporeal membrane oxygenation
acute kidney injury occurs in up to 30% of patients following cardiac surgery.  mortality increases by 60-80% in post-cardiopulmonary bypass patients who go on to require renal replacement therapy.  preoperative creatinine greater than 1.2 mg/dl, combined valve and bypass procedures, emergency surgery, and preoperative intraaortic balloon pump are risk factors most strongly correlated with post-cardiopulmonary bypass acute kidney injury.  other well-known minor risk factors include: female gender, congestive heart failure, chronic obstructive pulmonary disease, insulin-requiring diabetes, and depressed left ventricular ejection fraction.









































section::::causes.:prerenal.
acute kidney injury