A neonatal patient is receiving venovenous bypass ECLS and suddenly develops cardiac insufficiency. What should the therapist recommend for this patient at this time?

A. Increase the patient's fluid volume.
B. Administer an antihypertensive medication.
C. Provide inotropic drugs.
D. Institute HFV with inhaled nitric oxide.

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Venovenous bypass ECLS takes only a portion (i.e., 30% to 60%) of the cardiac output from the venous circulation, passes it through a membrane oxygenator, and returns it to the major veins. Venovenous ECLS is essentially adding another lung to the patient and is generally reserved for patients with adequate cardiac output. If cardiac insufficiency develops, the patient must be supported by inotropic drugs or surgically converted to venoarterial ECLS.
D. Incorrect response: See explanation C.