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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

Today, I want to continue from the last quick tip where I was talking about weaning off VA ECMO and that there shouldn’t be an intra-aortic balloon pump (IABP) present. Now, continuing from that quick tip, I also want to focus today on what else should be in place when someone is weaning from VA ECMO for acute heart failure after cardiac arrest, after cardiomyopathy, after a heart attack and so forth.

So one thing that should be in place when someone is weaning off VA ECMO is inotropes such as dobutamine and milrinone because they increase the contractility of the heart and they may also get blood pressure down a little bit. As part of the side effects for milrinone or dobutamine is that the systemic vascular resistance is dropping down slightly and that can be counteracted with a vasopressor such as noradrenaline or vasopressin, mainly noradrenaline or norepinephrine for our friends in the United States.

Once that’s in place, then the intensive care team should be starting with some weaning studies. They should be starting looking at Echo or ultrasound of the heart, potentially do even a transesophageal echocardiogram (TEE) for the heart to making sure ejection fraction is above 30% or 35%. And again, that should get the heart pumping to a degree where VA ECMO can be weaned.

The biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. And that’s where we can help very fast here at Intensive Care Hotline with our team of specialists that are specialized on intensive care consulting and advocacy for families in intensive care so that you can get the outcomes and results that you want, need and deserve for your loved one to maximize chances of survival and recovery.

So that’s my quick tip for today.

If you have a loved one in intensive care, go and check out intensivecarehotline.com. Call me on one of the numbers on the top of our website, or send me an email to [email protected].

Like this video, comment down below what questions that you have and subscribe to my YouTube channel for updates for families in intensive care.

This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.