VV and VA ECMO configurations, cannulation sites, circuit components, anticoagulation targets, flow and sweep adjustments, and complications.
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- What does VV ECMO support?
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Gas exchange (respiratory support) only, not hemodynamics.- What does VA ECMO support?
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Both gas exchange and hemodynamic (cardiac) support.- What is the primary indication for VV ECMO?
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Isolated severe respiratory failure with preserved cardiac function.- What is the primary indication for VA ECMO?
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Cardiogenic shock, or combined cardiac and respiratory failure.- What is the most common peripheral VV cannulation configuration?
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Drainage from the femoral vein, return to the internal jugular vein.- Which single vessel is used for a dual-lumen VV ECMO cannula?
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The right internal jugular vein.- What is recirculation in VV ECMO?
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Oxygenated return-cannula blood being drawn directly back into the drainage cannula without reaching the patient's systemic circulation.- What effect does high recirculation have on VV ECMO support?
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It lowers the effective oxygen delivered to the patient despite adequate pump flow.- What are the standard peripheral VA ECMO cannulation sites?
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Drainage from the femoral vein, return to the femoral artery.- What are the standard central VA ECMO cannulation sites?
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Drainage from the right atrium, return to the ascending aorta.- What is differential hypoxia (Harlequin/North-South syndrome) in peripheral VA ECMO?
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The upper body stays hypoxic from failing native heart/lungs while the lower body receives well-oxygenated ECMO blood.- Why is a distal limb perfusion catheter added alongside a femoral arterial cannula?
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To prevent limb ischemia distal to the arterial cannula.- What are the five core components of an ECMO circuit?
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Cannulas, tubing, pump, oxygenator, and heat exchanger.- What type of pump is most commonly used in modern ECMO circuits?
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A centrifugal pump.- How does a centrifugal pump generate blood flow?
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A spinning impeller uses centrifugal force to move blood; resulting flow depends on preload and afterload.
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