For VA neoECMO, a common cannulation combination is which pair of vessels?

• A. Right Internal Jugular and Right Carotid
• B. Left Internal Jugular and Left Carotid
• C. Right Femoral Vein and Right Femoral Artery
• D. Left Subclavian and Left Carotid

Answer: (A)

In VA ECMO, blood is drained from the venous system and returned to the arterial system to support both circulation and oxygenation. In neonates, a very common setup is to drain from the right internal jugular vein and return via the right carotid artery. This neck configuration is favored because the right IJ provides reliable central venous access for drainage in a small patient, and the right common carotid artery offers accessible arterial return into the systemic circulation. Returning oxygenated blood through the carotid helps ensure effective cerebral perfusion and avoids the limb ischemia risks associated with femoral arterial cannulation. While other peripheral configurations exist, this neck pair is widely used as a standard approach in neonatal VA ECMO due to practicality and perfusion considerations.