Quick tip for families in intensive care: Weaning off VA ECMO and VV ECMO simultaneously?

https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-weaning-off-va-ecmo-and-vv-ecmo-simultaneously/

Quick tip for families in intensive care: Weaning off VA ECMO and VV ECMO simultaneously?

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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So currently we’re working with a client who is on VA ECMO, balloon pump, and is also in lung failure and the client is asking what needs to happen to remove VA ECMO. And then they’re asking what needs to happen to remove VV ECMO for lung failure. So the plan for the client is to be removed from VA ECMO for heart failure after a heart attack. And then the next step is the client will go back on VV ECMO, which is for lung failure. And then they’re asking what needs to happen for both ECMOs to be removed.

So let’s dive right into this very quickly. So for VA ECMO for heart failure to be removed, what needs to happen is, the cardiac output needs to be sufficient and cardiac index needs to be sufficient. Cardiac output needing to be around 7 mls per kilo for a 90-kilo man that needs to be around 7 liters per minute.

So that’s what needs to happen to remove VA ECMO, but also they need a little bit of inotropic support, such as milrinone and dobutamine. The balloon pump needs to be removed as well. Maybe they need a little bit of noradrenaline to maintain blood pressure, especially the mean arterial blood pressure needs to be above 65 as well.

Continuation...
https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-weaning-off-va-ecmo-and-vv-ecmo-simultaneously/