This study addresses the critical issue of oxygenator failure during cardiopulmonary bypass (CPB), a rare but high-risk event. It explores protocols and techniques for addressing oxygenator malfunction, including traditional oxygenator change-outs and alternative approaches like arterial and venous piggyback methods. The authors emphasize the need for institutional preparation, including written protocols and routine emergency drills, and propose a venous piggyback technique as a safer first-line response to improve patient outcomes.