Treatment usually involves a stepwise approach, considering myocardial and pulmonary recovery. This can be addressed by increasing peripheral VA-ECMO flows to divert blood away from the native flow, optimizing mechanical ventilatory support to improve native oxygenation and ventilation, or an additional venous cannula can be placed to return oxygenated blood into the native circulation.

References

• ELSO Guidelines for Cardiopulmonary Extracorporeal Life Support Extracorporeal Life Support Organization, Version 1.4. Accessed May 14, 2023. www.elso.org
• Rao P, Khalpey Z, Smith R, Burkhoff D, Kociol RD. Venoarterial extracorporeal membrane oxygenation for cardiogenic shock and cardiac arrest. Circ Heart Fail. 2018;11:e004905.