What is the recommended intervention for treating low flows on ECMO?

In the context of managing low flows on ECMO, the recommended intervention is to correct hypovolemia. Low flows can be a direct result of inadequate blood volume being returned to the ECMO circuit. Hypovolemia contributes to decreased venous return, which limits the amount of blood that can be pumped by the ECMO system. Therefore, addressing hypovolemia through volume resuscitation—such as administering fluids or blood products—can help restore adequate blood volume, which in turn can improve flow rates in the ECMO circuit.

When hypovolemia is corrected, it often leads to an increase in the preload to the circuit, allowing the pump to function more effectively and maintain adequate flow rates. This intervention is foundational since ensuring that the patient has an optimal intravascular volume is crucial for the ECMO system to perform as intended.

The other options presented may be relevant in different contexts but do not address the immediate issue of low flows as directly as correcting hypovolemia does. Notifying the surgeon might be an important step in a broader context, especially if complications are suspected, but it won’t resolve the low flow issue itself. Adding additional cannulas can be an option if problematic cannulation is suspected, but it is