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Matteo Giunta1, Elisa G Recchia1, Paolo Capuano1, Antonio Toscano1, Matteo Attisani2, Mauro Rinaldi2, Luca Brazzi1
1 Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
2 Department of Cardiovascular and Thoracic Surgery, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
Correspondence Address:
Matteo Giunta
Department of Anesthesia and Critical Care, Citta della Salute e della Scienza di Torino, University of Turin, Corso Bramante 88-90, 10126, Turin
Italy
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/aca.aca_176_21
The use of ECPELLA in patients with severe lung disease may result in an unfavorable phenomenon of differential hypoxia. The simultaneous evaluation of three arterial blood samples from different arterial line (right radial artery, left radial artery, ECMO arterial line) in patients at risk of Harlequin syndrome (also called differential hypoxemia (DH)) can localize the “mixing cloud” along the aorta. Focusing the attention on the “mixing cloud” position instead of on isolated flows of Veno-Arterial Extracorporeal Membrane Oxygenation (VA ECMO) and Impella CP makes the decision making easier about how to modify MCSs flows according to the clinical context. Herein, we present two cases in which ECPELLA configuration was used to treat a cardiogenic shock condition and how the ECPELLA-induced hypoxia was managed.
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