Article description

Summary:

• The article aim was to describe the use and safety of transesophageal echocardiography (TEE) for extracorporeal membrane oxygenation (ECMO) cannulation for confirmed COVID-19 patients;
• Single-center retrospective cohort study;
• The study included 107 patients with diagnosed SARS-CoV-2 infection who underwent bedside venovenous ECMO (VV ECMO) cannulation under TEE guidance between May 2020 and June 2021;
• Primary outcome: TEE-guided bedside cannulations was successful in 99% of the patients without major complications;
• Secondary outcome: no TEE related complications were diagnosed, 1 pneumothorax (1%) was diagnosed with TEE during cannulation;14 patients (13%) required cannula repositioning during ECMO support.
• Using bedside TEE for VV ECM cannulation was safe for all patients and for the treatment team.

Conclusions:

• Bedside TEE guidance for VV ECMO cannulation is safe in patients with severe respiratory failure due to COVID-19;
• Further studies with a larger population are needed to determine risks for rare but severe complications related to VV ECMO cannulation under TEE guidance;