Pump controlled retrograde trial off (PCRTO) is a weaning technique for venoarterial ECMO (VA-ECMO) in which pump speed is gradually decreased until net retrograde flow develops from the arterial to the venous limb of the circuit. This maneuver suspends mechanical circulatory support without decannulation, offering a real-time, physiologic test of native…
Peripheral venous-arterial (VA) ECMO, typically via the common femoral vein and artery, can be utilized as a bridge to recovery or decision in critically ill patients; however, this cannulation strategy can result in unique physiologic derangements like a watershed phenomenon. In this situation, perfusion occurs via antegrade cardiac output (blood…
Virchow’s triad of stasis, vascular damage, and hypercoagulability contribute to thrombosis. Although patients on extracorporeal membrane oxygenation (ECMO) are usually on pharmacologic anticoagulation (i.e., heparin), it’s still possible to form clots in areas of sluggish flow such as Y-connectors and the membrane oxygenator.
Extracorporeal membrane oxygenation (ECMO) has a few basic parts: an inflow (“drainage”) cannula, mechanical blood pump, membrane oxygenator, heat exchanger, and an outflow (“return”) cannula. In a motor failure, pump flow can be maintained via a hand crank while troubleshooting the problem.