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Fig. 2 | Critical Care

Fig. 2

From: Optimizing PO2 during peripheral veno-arterial ECMO: a narrative review

Fig. 2

Clinical pictures illustrating the challenge of oxygenation during peripheral VA-ECMO. The yellow bullet corresponds to the mixing zone location; a When heart function is severely impaired, the mixing zone is in the proximal aorta and the risk is severe hyperoxemia of the whole body; b If there is minimal residual stroke volume and severe lung impairment, the mixing zone is above the coronary arteries but below the brachio-cephalic trunk. Then, the risk is unknown coronary hypoxemia; c When the heart recovers, the mixing zone moves down in the descending aorta. The risk is unknown hyperoxemia because continuous monitoring of PPOSTO2 is not widely available; d When the mixing zone is in the descending aorta, if severe lung impairment is associated, the risk is fulminant differential hypoxemia (Harlequin syndrome) with severe coronary and brain hypoxemia

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