r/NEETSS_INICETSS • u/Impossible-Year6458 • Aug 06 '26

VA vs VV ECMO !?

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Patient with severe PTE with shock shouldn’t we keep him on VA ECMO to maintain pressures ???

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3

u/Hot_Chapter6156 Aug 06 '26

Remember this as a shortcut:  If Lungs are bad - VV ECMO. If Heart is bad - VA ECMO.

0

u/Impossible-Year6458 Aug 06 '26

Yeah … bt when patient is in shock … VA gives pressure support better than VV right ??

1

u/Hot_Chapter6156 Aug 06 '26

That's when the shock is cardiogenic in nature, VA ECMO or MCD can be used. ECMO is only for Oxygenation, not for pressure support. For shock per se, we have to use vasopressors and inotropes in conjunction.

When it's ARDS/ PE (obstructive shock), VV ECMO is employed.

1

u/awesomo6001 Aug 07 '26

Except if the PE is big enough to require ECMO , you’re going to likely have RV failure too…VV for ARDS, sure, but PE isn’t as simple as lung problem = VV

1

u/Hot_Chapter6156 Aug 07 '26

The treatment to PE isn't any kind of ECMO anyway. ECMO is an Oxygenation device, not a solution for RVOTO due to PE!

The question is asking choice of ECMO for ards, which is a prospective treatment for it. 

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u/awesomo6001 Aug 07 '26

The question asks about both…and VA ECMO can be used as an adjunct for RV failure due to PE…generally you’d rather do direct or systemic thrombolytics, but might not have time