Hidden Harlequin syndrome in neonatal and pediatric VA-ECMO

[...]the reduction in the left ventricular preload by a large interatrial communication or the presence of LV dysfunction may be so important that the aortic valve remains closed, VA-ECMO then provides full circulatory support, no HS exists and the coronaries arteries are well oxygenated (Fig. 1C)....

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Published in:Critical care (London, England) England), 2022-05, Vol.26 (1), p.146-146, Article 146
Main Authors: Levy, Yael, Starck, Julie, Mary, Anne-Lise, Soreze, Yohan, Jean, Sandrine, Kreitmann, Bernard, Léger, Pierre-Louis, Rambaud, Jerome
Format: Article
Language:English
Subjects:
Autonomic Nervous System Diseases
Blood oxygenation, Extracorporeal
Child
Complications and side effects
Coronary vessels
Correspondence
Critical care
Diagnosis
Extracorporeal Membrane Oxygenation
Flushing
Human health and pathology
Humans
Hypohidrosis
Infant, Newborn
Lamellar ichthyosis
Life Sciences
Pediatric research
Pediatrics
Retrospective Studies
Veins & arteries
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Summary:[...]the reduction in the left ventricular preload by a large interatrial communication or the presence of LV dysfunction may be so important that the aortic valve remains closed, VA-ECMO then provides full circulatory support, no HS exists and the coronaries arteries are well oxygenated (Fig. 1C). [...]adding a re-injection cannula in the femoral vein to offer a hybrid veno-arterio-venous ECMO will help to ensure coronary oxygenation by potentially increasing transpulmonary blood flow and oxygen content of pulmonary blood at the cost of recirculation [5]. [...]HS must be suspected and prevented in all VA-ECMO patients in order to avoid a prolongated or a secondary/recurrent cardiac dysfunction.
ISSN:1364-8535
1466-609X
1364-8535
1366-609X
DOI:10.1186/s13054-022-04017-w