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Risks involved in ECMO can be due to the initiation and placement of cannula eg. damage to blood vessels and heart, hematomas, pneumothorax etc. but these are very uncommon and further minimized by using ultrasound and echocardiographic guidance for placement of cannulas. On ECMO, there is a risk of bleeding: externally or internally; as patient needs to be administered heparin as an anticoagulant so that blood does not clot in the ECMO circuit, which can be fatal. Most of the bleeding is minor and non-life threatening and easily manageable. Rarely, internal bleeds into the abdomen and brain can occur which can be fatal. These events are minimized by close monitoring of heparin dose. Acquired infections on ECMO are also a possibility due to the foreign invasive devices.

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