Central VA-ECMO What Could Possibly Go Wrong?

This is a case study presentation of a male patient that presented to the ER with chest pain he was taken to the OR for a CABG. He went into cardiac arrest and was cannulated for central VA ECMO with an Impella device. Patient was in profound cardiogenic shock with vasoplegia on 2 mechanical circulatory devices. He was intubated, with multiple chest tubes and an open chest. Upon our arrival to the OR they were packing his chest for the second time from multiple bleeding sites. He was profoundly hypotensive. We had to provide treatment to stabilize him enough to move him. He also had an arterial line and a Swanz-Ganz catheter. This presentation will cover what was going on in the OR when we arrived, what we did to treat and stabilize the patient and how we were able to successfully transport this patient by helicopter to the receiving CVICU.

Session Outline:
Brief overview of ECMO
I will cover central VA ECMO to include what it is and how it works to include how it works with an Impella device-10 minutes
Review case presentation
I will cover how the patient ended up in the ER, what occurred in the OR, how it all progressed until we were called this will cover all the equipment that the patient was on and what the equipment was doing and how this was correlating with his presentation. This includes the centrimag ecmo device, Impella 5.5, arterial line, Swanz-Ganz catheter and multiple chest tubes -15 minutes
Discuss treatments provided
I will cover all the things we did to provide treatment to the patient and how those treatments were decided upon as a crew-15 minutes
Discuss transport considerations
I will cover what occurred during transport and the treatment we did in flight -15 minutes
Questions
I will leave 5 minutes at the end for any questions-5 minutes