Lung rest is the primary goal of venovenous extracorporeal membrane oxygena
tion for severe acute respiratory failure. To achieve this there has to be
adequate extracorporeal flow. This can be achieved by a two-cannula techniq
ue in most cases. In some cases, extra flow is either not achievable or cau
ses excessive recirculation. We report 8 patients in whom we achieved adequ
ate blood and oxygen delivery using a three-cannula technique. Five patient
s survived (62.5%). (C) 2000 by The Society of Thoracic Surgeons.