VA-ECMOadvanced8 min
Harlequin: splice the Y, then clamp it
Handover
Fem-fem VA, native output returning. Right-hand sat 76%, legs pink. The RIJ is prepped and the Y is on the field — they want you to convert to V-AV. No Hoffman clamp is out yet. MAP 76 on modest pressor. Splicing the venous return without clamping it trades Harlequin for shock.
Uncorrected hypoxemia, shock, or a dead circuit progresses to pre-arrest, then a code.
Goals
- · Converted to V-AV
- · Qart ≥ 2.0 L
- · Qven ≥ 1.0 L
- · Upper SpO₂ ≥ 88%