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J Extra Corpor Technol · Mar 2015
Case ReportsVariability in End-Organ Perfusion with Femoral-Femoral Venoarterial Extracorporeal Membrane Oxygenation: Aortographic Evidence.
- Andreas R de Biasi, William J DeBois, Luke Kim, and Arash Salemi.
- J Extra Corpor Technol. 2015 Mar 1;47(1):48-51.
AbstractIn femoral-femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO), the outflow of oxygenated blood from the circuit enters the aorta in retrograde fashion. As a result, variability in end-organ oxygenation (e.g., cerebral vs. splanchnic) may arise-particularly, when the heart is unable to contribute forward flow. We present the case of a 74-year-old man supported by femoral-femoral VA-ECMO in whom aortography was used to visualize the retrograde distribution of arterial ECMO flow that can produce such differences in end-organ perfusion. We do this by describing a series of still images captured during the aortography; we then discuss the importance of monitoring end-organ oxygenation in this setting and outline several interventions that can ameliorate this flow phenomenon.
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