Table A1

- Venous insufficiency.

Change in venous cannula positionReduce pump speed (rpm) temporarily and optimize ventilator settingsThis will improve venous drainage until the cause is addressed and there is definitive management
HypovolemiaIf patient is hypovolemic due to high urine output: Aggressive diuresis, bleeding, etc.Volume assessment Give volume/transfuse
Other causes of increased intrathoracic or abdominal pressure (pneumothorax, cardiac tamponade, intrabdominal bleeding, and so on)Change the patient position and/or venous cannula positionTip migration Check by x-ray
 Check tubing and pump head for fibrin or clotConsider changing the cannula or circuit
Venous line obstruction by clot or kink or twistConsider FAST (focused assessment with sonography for trauma) exam and manage accordinglyMay require surgical intervention