V-VA-ECMOadvanced8 min
V-VA: the artery is the high-resistance limb
Handover
VV for ARDS. Overnight the RV failed — MAP 48, rising lactate, echo D-sign. An arterial return was Y’d off the post-membrane tubing (V-VA). Total flow is still 4.3 L, but almost all of it returns to the RA. The new 17-Fr arterial cannula barely registers. The artery is the high-resistance limb.
Uncorrected hypoxemia, shock, or a dead circuit progresses to pre-arrest, then a code.
Goals
- · Qart ≥ 2.0 L
- · MAP ≥ 62
- · Qven ≥ 1.0 L
- · SpO₂ ≥ 88%