Cannulation strategies for intraoperative mechanical cardio-respiratory support in general thoracic surgery

: In general thoracic surgery, extracorporeal mechanical cardio-respiratory support (EMCS) techniques are performed intraoperatively mainly for respiratory but also cardiocirculatory support. The increasing panel of EMCS technologies available in surgery is the result a century clinical practices, engineering progress, and improvements physiological knowledge. Complex procedures tumor resection, traqueal main airway or lung transplantation scenarios where these should be considered if needed. aim this review to describe different modalities used with particular attention cannulation techniques. Venovenous membrane oxygenation (VV-ECMO) most common modality represents efficient supporting function. Venoarterial ECMO (VA-ECMO) may achieved both central peripheral cannulation. Central VA-ECMO intraoperative emergent support, which brought decrease popularity classic cardiopulmonary bypass (CPB) due lower risk complications. Peripheral traditionally femoro-femoral configuration. Extracorporeal CO2 removal (ECCO2R) Novalung marginal alternatives during surgery. Although rarely used, ECMS part every surgeon armamentarium mind complex cases emergency settings.