Ramp-Down/Ramp-Up Protocol for Biventricular Dysfunction Management With ECpella Support.

ABSTRACT:

Objective

Managing severe biventricular dysfunction with venoarterial extracorporeal membrane oxygenation (ECMO) and Impella requires a strategic approach. The ramp-down/ramp-up protocol standardizes care for such complex cases.

Key steps

Key monitoring tools include pulmonary artery catheter echocardiography (transesophageal echocardiography/transthoracic echocardiography), end-tidal CO₂, invasive blood pressure, and blood gases. The primary goal is to ensure adequate oxygen delivery with mixed venous oxygen saturation (>65%). After stabilization (6-12 hours), ventricular function is evaluated every 12 hours to adjust ECMO and Impella support. Right ventricular function is assessed by progressively reducing ECMO, whereas left ventricular function is evaluated by

SUBMITTER: Vitali Rosati B 

PROVIDER: S-EPMC12441439 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature