• Dominik J Vogel, Josie Murray, Adam Z Czapran, Luigi Camporota, Nicholas Ioannou, Chris I S Meadows, Peter B Sherren, Kathleen Daly, Nigel Gooby, and Nicholas Barrett.
• 1 Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, UK.
• Perfusion. 2018 May 1; 33 (1_suppl): 57-64.

IntroductionThe role of extracorporeal support for patients with septic shock remains unclear.MethodsWe conducted a retrospective analysis of our single-centre experience with veno-arterio-venous extracorporeal membrane oxygenation (VAV ECMO) in adult patients with severe respiratory failure and septic cardiomyopathy. Clinical data was extracted from electronic medical records including a dedicated ECMO referral and follow-up database.ResultsTwelve patients were commenced on VAV ECMO for septic cardiomyopathy for a median of four days (IQR 3.0 to 5.3) between 01/2014 and 12/2017. Five patients (41.7%) had a cardiac arrest prior to initiation of ECMO support. At baseline, median left ventricular ejection fraction was 16.25% (IQR 13.13 to 17.5) and median PaO2/FiO2 ratio was 9 kPa (IQR 6.5 to 12.0) [67.50 mmHg (IQR 48.75 to 90.00)]. The survival rate to hospital discharge for VAV ECMO was 75% in this cohort. None of the surviving patients died within the follow-up period (median six month).ConclusionVAV ECMO is a feasible rescue strategy for a small proportion of patients with combined respiratory and cardiac failure secondary to septic shock with septic cardiomyopathy. We provide a detailed report of our experience with this technique. Further research is required comparing the different extracorporeal strategies directly to conventional resuscitation and against each other.

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