Cardiac Support: Emphasis on Venoarterial ECMO

Crit Care Clin. 2017 Oct;33(4):777-794. doi: 10.1016/j.ccc.2017.06.002. Epub 2017 Jul 21.

Abstract

Major advances have been made in mechanical circulatory support in recent years. Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) provides both pulmonary and circulatory support for critically ill patients with hemodynamic compromise, serving as a bridge to recovery or definitive therapy in the form of transplant or a durable ventricular assist device. In the past, VA ECMO support was used in cases of cardiogenic shock or failure to wean from cardiopulmonary bypass; however, the technology is now being applied to an ever-expanding list of conditions, including massive pulmonary embolism, cardiac arrest, drug overdose, and hypothermia.

Keywords: Cardiogenic shock; Extracorporeal cardiopulmonary resuscitation; Pulmonary embolism; Pulmonary hypertension; Venoarterial extracorporeal membrane support.

Publication types

  • Review

MeSH terms

  • Cardiopulmonary Resuscitation / methods*
  • Critical Illness
  • Drug Overdose / therapy
  • Extracorporeal Membrane Oxygenation / methods*
  • Heart-Assist Devices
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / therapy*
  • Hypothermia / therapy
  • Pulmonary Embolism / therapy*
  • Shock, Cardiogenic / therapy*