Cases/

Case 25 — Hybrid circuit, falling MAP

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V-AV-ECMOadvanced8 min

Case 25 — Hybrid circuit, falling MAP

Handover

Fem-fem VA for cardiogenic shock. Native output recovered and the right hand desatted, so the team spliced a RIJ venous return. Right-hand sat is now 93%, but MAP is 52 and falling. Total pump flow 4.6 L. No clamp on the Y. Bedside Doppler: Qven 3.5 L, Qart 1.1 L.

Uncorrected hypoxemia, shock, or a dead circuit progresses to pre-arrest, then a code.

Goals

  • · Qart ≥ 2.2 L
  • · Qven ≥ 1.0 L
  • · MAP ≥ 64
  • · Upper SpO₂ ≥ 88%