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Differential hypercapnia: Recognition, management, and outcomes in an awake patient supported with peripheral veno-arterial extracorporeal membrane oxygenation

Year: 2026

Type: article

Abstract: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a life-saving intervention for individuals with refractory cardiopulmonary failure and is associated with several complications. Differential hypercapnia, also known as RIDDLER syndrome or East-West Syndrome, is a complication, at times exacerbated iatrogenically, where competitive flow dynamics lead to relative increase in carbon dioxide delivery from the descending aorta in awake patients supported with peripheral VA-ECMO. This case report presents the clinical course, diagnostic features, management, and outcome for a patient who developed differential hypercapnia during awake peripheral VA-ECMO cannulation and support.

Source: JHLT Open

DOI: 10.1016/j.jhlto.2026.100510

Authors: Terrance Oster, Casey Miller, Melissa Morris, Sarah Ruhland, C. Christopher Zalesky, Sagar B. Dave

Institutions: Emory Healthcare, Emory University

Language: English

Topic: Mechanical Circulatory Support Devices

Subfield: Biomedical Engineering

Field: Engineering

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500