VA-ECMO Simulator

Select a scenario
VA-ECMO · CICU—
VL/min
—
Crpm
—
PvenmmHg
—
PartmmHg
—
circuit
🩸 femoral ΔP — 🫀 AV open
Gas delivery — blender & sweep
Oxygen Blender · FiO₂ 21 50 70 100 100 % Sweep Gas L/min 0 2 4 6 8 10 4.0
Drag the FiO₂ dial or sweep float
SWEEP 4.0
Impella · ECPELLA
Plevel
OFF
QL/min
0.0
P-level sets Impella output → cardiac unloading & forward flow
Mechanical Ventilation · Pressure Control
16
b/min
Rate
15
mbar
Pcontrol
5
mbar
PEEP
50
%
Oxygen
1.5
s
Insp. time
50
%
Lung function
Patient state
BED 7CICU VA-ECMO MONITOR —
ECG II
ART
Pleth · R arm
Pleth · Leg
CVP
HR bpm
—
ART mmHg
—
—
SpO₂ R-arm %
—
preductal
SpO₂ Leg %
—
postductal
CVP mmHg
—
Pre-Oxygenator—
Post-Oxygenator—
ΔP Oxygenator—
Right arm
preductal · brain+coronary
–
Left arm
aortic arch
–
Leg
postductal · ECMO zone
–
MAP
–
mmHg
Lactate
–
mmol/L
Pulse pressure
–
mmHg
PCWP
–
mmHg
Native CO
–
L/min
Aortic valve
–

Treatment

Tick an intervention to apply it. Some are correct, some are traps — watch the monitor & Evaluate respond.

Evaluate

Teaching module — diagnosis & treatment table
ScenarioDiagnosisCorrect treatmentGoals
HarlequinDifferential hypoxiaLung recruitment · ↑vent FiO₂ · convert axillary/centralR radial SaO₂ ≥90 · R cerebral rSO₂ ≥60
LV ballooningLV distension, no ejectionInotrope · Impella · IABP · ↓ECMO flow (RPM)AV opens · PCWP ≤18
Limb ischemiaDistal limb ischemiaDistal perfusion cannula · downsize cannulaLimb NIRS ≥60 · no compartment
ECPELLACardiogenic shock, needs unloadingImpella (raise P-level)MAP ≥65 · PCWP ≤14 · PP ≥10
WeaningRecovery assessmentTurn RPM down stepwise; no new devicesMAP ≥60 · lactate <2 · PP ≥15
Traps: ↑RPM in Harlequin/ballooning · transfuse for ballooning/limb · devices during weaning.
ARTERIAL BLOOD GAS sample: right radial · preductal pH: 7.41 pCO₂: 38 mmHg pO₂: 95 mmHg HCO₃⁻: 24 mmol/L sO₂: 98 % BE: +1.5 mmol/L Hb: 12.0 g/dL Lactate: 1.2 mmol/L
Post-oxy PaO₂
–
mmHg · FiO₂-driven
Post-oxy PaCO₂
–
mmHg · sweep-driven
NIRS monitoring
Cerebral rSO₂
Cerebral NIRS
—
—
R hemisphereL hemisphere
Lower-limb rSO₂
Lower-limb NIRS
—
—
R lower limbL lower limb
rSO₂ <60% (red, pulsing) = regional desaturation. Right side = cannulated / preductal.
Aortic transition point
Transition point = where ECMO & native blood meet. Above (proximal) dark = native (less O₂) · below (distal) bright red = ECMO. Weak heart → point rises toward the valve.