Abstract:Objective To explore the application value of transthoracic echocardiography,vascular ultrasound and abdominal ultrasound in evaluating the basic situation of patients before undergoing venous-arterial extracorporeal membrane oxygenation (V-A ECMO) and in monitoring complications during V-A ECMO. Methods A total of twenty-one patients with heart failure undergoing V-A ECMO support treatment from April 2018 to August 2019 were included.Assessed by echocardiography,vascular ultrasound and abdominal ultrasound,the patients′ basic condition before intubation and the changes in cardiac and vascular during intubation,V-A ECMO and after ECMO support and related complications were analyzed. Results There were 12 cases of acute coronary syndrome,5 cases of fulminant myocarditis,3 cases after cardiac surgery,1 case of cardiac arrest,5 cases (23.8%) died during ECMO support treatment,16 cases (76.2%) survived to extubation and 10 cases (47.6%) survived to discharge.Before ECMO,there were 2 cases(9.5%) with normal left-ventriculas systolic function,19 cases (90.5%)with abnormal left-ventricular systolic function,including 3 cases of mild reduction,9 cases of moderate reduction and 7 cases of severe reduction.There were 14 cases (66.7%) with normal right-ventricular systolic function and 7 cases (33.3%) with abnormal right ventricular systolic function. Six patients(28.6%) needed to select the lighter side of stenosis for intubation according to the results of femoral atherosclerosis before intubation. During intubation,ultrasound monitoring showed that there were 15 cases (71.4%) of successful initial intubation,6 cases (28.6%) needed to adjust the end position of the cannula under the guidance of ultrasound and 2 cases (9.5%) needed to adjust or reestablish the collateral circulation.Ultrasound monitoring during and after ECMO support treatment showed 1 case (4.8%) needed to adjust the end position of the cannula under the guidance of ultrasound.Thromboembolism was the main complication,including 2 cases (9.5%) of thrombosis around the venous catheter during supportive treatment and 2 cases (9.5%) at the femoral artery suture after offline.No adverse events occurred during the V-A ECMO period. Conclusion With the preoperative evaluation and guidance of ultrasound,the success rate of single-lumen V-A ECMO intubation is very high,and the complications can be found immediately,which can help to reduce the occurrence of severe complications druing peri-treatment period of the V-A ECMO.