• Curr Opin Anaesthesiol · Feb 2023

    Review Meta Analysis

    Is venoarterial extracorporeal membrane oxygenation an option for managing septic shock.

    • Mohammad A Helwani and Aaron Lim.
    • Washington University, Department of Anesthesiology, St. Louis, Missouri.
    • Curr Opin Anaesthesiol. 2023 Feb 1; 36 (1): 454945-49.

    Purpose Of ReviewTo describe sepsis-induced cardiomyopathy. Discuss indications and current evidence of using venoarterial extracorporeal membrane oxygenation (VA-ECMO) in setting of sepsis-induced cardiomyopathy.Recent FindingsRecent data suggests a survival benefit with the use of VA-ECMO in patients with septic shock complicated by septic-induced cardiomyopathy with severe left ventricular systolic dysfunction. VA-ECMO was associated with poor outcomes in adults with septic shock without severe systolic dysfunction. The evidence is generated from retrospective and meta-analysis of observational studies.SummarySepsis-induced cardiomyopathy is an increasingly recognized entity characterized by reversible ventricular dysfunction in the setting of sepsis. When hypotension persists despite standard management of septic shock (e.g. adequate fluid resuscitation, vasopressors, inotropes) and there is evidence of severe cardiac systolic dysfunction and end-organ hypoperfusion, VA-ECMO should be considered as a bridge therapy to recovery. VA-ECMO should not be used for isolated vasodilatory septic shock without significant myocardial dysfunction.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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