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Schematic diagram of the protocol. The extracorporeal membrane oxygenation–cerebral selective deep hypothermia (ECMO–CSDH) protocol uses two independent extracorporeal circuits: the one for standard ECMO is established using a cut-down in the emergency room and continues for 3–5 days; the other is established by a single standard femoral percutaneous puncture for placement of the TwinFlo cannula. CSDH circuit inserts, operates, and may be removed independently of the ECMO circuit.
