VA-ECMOintermediate7 min
Pulse pressure vanishing
Handover
VA with rising support. Pulse pressure is 6 mmHg, CVP 20, lactate climbing. Adding RPM does not help the perfusion markers. Yesterday’s echo: aortic valve barely opening, smoke in the LV. The fellow wants more flow “for safety.”
Uncorrected hypoxemia, shock, or a dead circuit progresses to pre-arrest, then a code.
Goals
- · LV unloaded
- · Pulse pressure ≥ 15
- · Lactate improving