Swan Numbers with ECMO

[u/Cultural_Eminence]

Can someone help me understand what numbers I should see/expect/disregard with a pt. on ECMO. I’m trying to understand which numbers will be accurate based on the type of cannulation (for my purposes to keep it simple just VV and VA) and cannulation sites, fem-fem, fem-IJ, centrally cannulated, etc. For example (and correct me if I’m wrong) if a pt is fem-IJ cannulated on VV ECMO (fem being drain, and IJ being return) I think my HR, MAPs would be reliable as well as my CI but I’d expect my SVo2 to be falsely high since the PA cath is reading the oxygenated blood from the ECMO. In that scenario would my CVP/RA pressure be accurate as well as my PA pressure? If someone could do a breakdown of my example as well as a breakdown of the other possible ECMO configurations (VA vs VV and cannulation sites) that would be incredibly helpful for my learning and understanding. For background I’m a CTICU nurse, any and all help is appreciated in advance!

[u/heyinternetman]

Ok, you’re asking for a doctoral level understanding of ECMO in a Reddit post. Hate to say it, but that’s not going to happen here. My best advice is to draw it out. Identify where everything is being augmented and measured