VA ECMO is for patients who are experiencing acute severe cardiac failure and it provides direct circulatory and respiratory support 
VA ECMO
What is V-A ECMO | Veno-Arterial ECMO
Let’s ask the question what is V-A ECMO so V-A ECMO is for patients who are experiencing acute severe cardiac failure and it provides direct circulatory and respiratory support. That’s the key thing about VA ECMO is that it is going to take over for your heart and your lungs so if you’re not sure in an emergency situation why the patient has gone into shock cardiogenic shock, respiratory shock. If you’re not sure you don’t have time to diagnose VA ECMO is usually the first thing that’s going to be tried then we’ll sort it out later. V-A ECMO is indicated in patients with primary cardiac failure resulting in cardiogenic shock or cardiac arrest that’s refractory to conventional medical therapy and here you talked about the goal of V-A V-V ECMO being a 60 of the cardiac output. The goal of V-A ECMO is a little bit more elaborate because again we’re taking over for the heart and the lungs we should be able to on VA equal maintain a reasonable mean arterial pressure of 60 or greater. We ideally would maintain an arterial saturation of greater than 85 percent and we should be able to maintain normal carbon dioxide normal lactate levels and normal ph levels. A little bit of a take-home message here for people who are not very well adept at ECMO is your lactate levels on ECMO will always tell you a lot if you have started off with a high lactate because the patient’s in failure and you put them on ECMO and your lactates are coming down to normal generally is a very good sign you’re doing something right the reverse is also true. If you’re on ECMO and your lactates are continuing to rise or stay stay elevated you need to look into some uh into improving what you’re doing oh that could just be dead gut, because that’s if you’ve got problems. If your lactates aren’t coming down yeah if you’ve had to leave a fed on you know for a couple of days at 28 mics or higher a good chance you’re going to have going to have a big old bowel infarct we see that unfortunately.
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VA ECMO is indicated in patients with primary cardiac failure resulting in cardiogenic shock or cardiac arrest that's refractory to conventional medical therapy