The ProtekDuo® is a dual lumen cannula that can be used in numerous configurations to treat cardiogenic shock and hypotension. Its default function is as a temporary percutaneous right ventricular assist device (RVAD) system, however, other configurations both alone and with other mechanical circulatory support (MCS) devices have evolved. In addition to its use as a component of a ventricular assist device (VAD), it can be used as a cannula for extracorporeal membrane oxygenation (ECMO) and may serve as double lumen drainage cannula on cardiopulmonary bypass (CPB). The role of the cannula in ECMO has been described in multiple configurations including traditional veno-pulmonary (V-P) or “oxygenated RVAD” (oxyRVAD), veno-venopulmonary (V-VP), or venopulmonary-arterial (VP-A). This book chapter summarizes various configurations and technical aspects of the ProtekDuo(R) cannula in the management of hypotension and cardiogenic shock.