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Circ Heart Fail. 2018 Sep;11(9):e004905. doi: 10.1161/CIRCHEARTFAILURE.118.004905.

Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest.

Author information

1
Sarver Heart Center, University of Arizona, Tucson (P.R.).
2
Division of Cardiothoracic Surgery, Department of Surgery, University of Arizona, Tucson (Z.K.).
3
Artificial Heart and Perfusion Programs, Banner University Medical Center, Tucson, AZ (R.S.).
4
Cardiovascular Research Foundation, Columbia University Medical Center, New York, NY (D.B.).
5
Advanced Heart Failure and Mechanical Circulatory Support Program, University of Massachusetts Memorial Medical Center, Worcester (R.D.K.).

Abstract

Venoarterial extracorporeal membrane oxygenation (VA-ECMO)-also referred to as extracorporeal life support-is a form of temporary mechanical circulatory support and simultaneous extracorporeal gas exchange. The initiation of VA-ECMO has emerged as a salvage intervention in patients with cardiogenic shock, even cardiac arrest refractory to standard therapies. Analogous to veno-venous ECMO for acute respiratory failure, VA-ECMO provides circulatory support and allows time for other treatments to promote recovery or may be a bridge to a more durable mechanical solution in the setting of acute or acute on chronic cardiopulmonary failure. In this review, we provide a brief overview of VA-ECMO, the attendant physiological considerations of peripheral VA-ECMO, and its complications, namely that of left ventricular distention, bleeding, heightened systemic inflammatory response syndrome, thrombosis and thromboembolism, and extremity ischemia or necrosis.

KEYWORDS:

extracorporeal membrane oxygenation; heart arrest; hemorrhage; shock, cardiogenic; thrombosis

[Indexed for MEDLINE]

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