Extracorporeal Membrane Oxygenation in Postcardiotomy Cardiogenic Shock

Methodist Debakey Cardiovasc J. 2023 Aug 1;19(4):66-73. doi: 10.14797/mdcvj.1256. eCollection 2023.

Abstract

Postcardiotomy extracorporeal membrane oxygenation (PC-ECMO), the most frequent indication for ECMO in the United States, is increasingly used as the first-line mechanical circulatory support in patients who are refractory to conventional treatment. Despite increasing use of PC-ECMO, limited evidence is available regarding its safety, efficacy, and optimal timing for initiation and weaning. The decision to use PC-ECMO often is made in the absence of robust clinical data, leading to variability in patient selection, management, and outcomes across different institutions. This article summarizes current evidence on ECMO use in postcardiotomy cardiogenic shock and discusses its potential benefits, management, complications, and outcomes.

Keywords: ECMO; LV unloading; cardiogenic shock; postcardiotomy shock.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Humans
  • Patient Selection
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy