Quantification of recirculation as an adjuvant to transthoracic echocardiography for optimization of dual-lumen extracorporeal life support.

Purpose: Proper cannula positioning in single site veno-venous extracorporeal life support (vv-ELS) is cumbersome and necessitates image guidance to obtain a safe and stable position within the heart and the caval veins. Importantly, image-guided cannula positioning alone is not sufficient, as possible recirculation cannot be quantified.
Methods and Results: We present an ultrasound dilution technique allowing quantification of recirculation for optimizing vv-ELS.
Conclusion: We suggest quantification of recirculation in addition to image guidance to provide optimal vv-ELS.