TY  - JOUR
AU  - Tavazzi, Guido
AU  - Avondo, Stefano 
AU  - Corradi, Francesco
TI  - Splanchnic ultrasound to guide unloading in VA-ECMO
PY  - %2026/%05/%07
Y2  - %2026/%08/%27
JF  - The Ultrasound Journal
JA  - Ultrasound J
VL  - 18
IS  - 1
SE  - Case Reports
DO  - 10.5826/tuj.2026.18796
UR  - https://doi.org/10.5826/tuj.2026.18796
SP  - 18796
AB  - Patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may require left ventricular (LV) unloading to prevent pulmonary congestion and adverse hemodynamic interactions. However, defining the need and timing of unloading remains challenging, as current approaches rely predominantly on cardiac and pulmonary parameters, often neglecting systemic and organ-level congestion. We report the case of a 53-year-old woman admitted with cardiogenic shock following pericardial drainage and mediastinal mass biopsy. Due to rapid hemodynamic deterioration, VA-ECMO was initiated, resulting in stabilization. Early echocardiographic assessment showed severe biventricular dysfunction but evidence of partial aortic valve opening without LV distension. To further characterize the hemodynamic profile, splanchnic Doppler ultrasound was performed, demonstrating preserved renal arterial flow (resistive index