Safety of tracheostomy on ECMO

Tracheostomy is recommended in case of prolonged mechanical ventilation and most patients undergoing venovenous extracorporeal membrane oxygenation (ECMO) will also have an indication for tracheostomy. However, there are several reports describing severe or fatal adverse events related to tracheostomy in these patients, including pneumothorax, hypotension or air embolism.

Lother et al. Tracheostomy in Patients on Extracorporeal Membrane Oxygenation: Is it Really Safe? J Intensive Care Med 2019

Lother et al. Fatal air embolism as complication of percutaneous dilatational tracheostomy on venovenous extracorporeal membrane oxygenation. J Cardiothorac Surg. 2016;11:102.