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Echocardiography provides essential diagnostic and anatomic information prior to ECMO initiation, allows for safe and efficient ECMO cannula positioning, guides optimization of flow, provides a modality for rapid troubleshooting and patient evaluation, and facilitates decision\u2010making for eventual weaning of ECMO support. Currently, guidelines for echocardiographic assessment in this clinical context are lacking. In this review, we provide an overview of echocardiographic considerations for advanced imagers involved in the care of these complex patients. We focus predominately on new cannulas and complex cannulation techniques, including a special focus on double lumen cannulas and a section discussing indirect left ventricular venting. Echocardiography is tremendously valuable in providing optimal care in these challenging clinical situations. It is imperative for imaging physicians to understand the pertinent anatomic considerations, the often complicated physiological and hemodynamic context, and the limitations of the imaging modality.<\/jats:p>","DOI":"10.1111\/echo.15266","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T04:42:41Z","timestamp":1641616961000},"page":"339-370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Echocardiography for extracorporeal membrane oxygenation"],"prefix":"10.1111","volume":"39","author":[{"given":"Patrick T.","family":"Hussey","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine Division of Cardiothoracic Anesthesiology  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"von Mering","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiovascular Disease  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navin C.","family":"Nanda","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiovascular Disease  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa I.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiovascular Disease  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3856-6419","authenticated-orcid":false,"given":"Dylan R.","family":"Addis","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine Division of Cardiothoracic Anesthesiology Division of Molecular and Translational Biomedicine, and the UAB Comprehensive Cardiovascular Center University of Alabama at Birmingham School of Medicine  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066619900503"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e328342722b"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.07.009"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-1042-2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.05.010"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.2424"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2020.04.002"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201004-0601OC"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.118.005512"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.118.008176"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2018.04.013"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(05)80340-2"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.4103\/aca.ACA_75_19"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001085"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10047-015-0824-2"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2017.12.013"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.10.069"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000709"},{"key":"e_1_2_6_20_1","volume-title":"Instructions for Use Avalon Elite\u00ae Bi\u2010Caval Dual Lumen Catheter","author":"Group MG","year":"2017"},{"key":"e_1_2_6_21_1","volume-title":"Crescent\u2122 Jugular Dual Lumen Catheter Instructions for Use","author":"Cardiopulmonary M","year":"2016"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0b013e31826feda5"},{"key":"e_1_2_6_23_1","volume-title":"Procedure Guide","author":"LivaNova","year":"2019"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.06.017"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000357"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-20-1515"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.13087"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2018.08.05"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001422"},{"key":"e_1_2_6_30_1","unstructured":"Full COVID\u201019 Registry Dashboard.2021.https:\/\/www.elso.org\/Registry\/FullCOVID19RegistryDashboard.aspx. 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