Related Experiment Video
Updated: Sep 19, 2025
03:40
Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
443
Redefining weaning in a VA ECMO: a case report on pump-controlled retrograde trial off
Raghavendra Deshpande1, Rajavardhan Rangappa1, Saikat Kanjilal2
1Department of Critical Care, Manipal Hospital Sarjapur Road, Bengaluru, 560102 India.
Indian Journal of Thoracic and Cardiovascular Surgery
|June 19, 2025
Summary
Pump-controlled retrograde trial off (PCRTO) offers a practical approach to weaning patients from veno-arterial extracorporeal membrane oxygenation (VA ECMO). This method, used with a pulmonary artery catheter, predicted successful ECMO weaning in a cardiogenic shock patient.
Area of Science:
- Cardiology
- Critical Care Medicine
- Cardiovascular Surgery
Background:
- Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is increasingly utilized for mechanical circulatory support in cardiogenic shock.
- Weaning protocols for VA ECMO vary significantly among institutions.
- Effective strategies are needed to safely manage patients during the transition from VA ECMO.
Observation:
- A 41-year-old male with acute coronary syndrome and cardiogenic shock required VA ECMO.
- Pump-controlled retrograde trial off (PCRTO) was employed as a weaning method, guided by a pulmonary artery catheter.
- The patient's cardiorespiratory recovery was uncertain during the weaning process.
Findings:
- PCRTO facilitated the successful removal of VA ECMO cannulae.
- The PCRTO method demonstrated feasibility and reversibility, acting as a preload stress test.
- Successful weaning from VA ECMO was predicted by the PCRTO approach.
Implications:
- PCRTO represents a valuable and physiological method for weaning patients from VA ECMO.
- This technique may improve patient outcomes by providing a reliable predictor of successful device explantation.
- Further investigation into PCRTO could standardize VA ECMO weaning protocols.
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