• Artificial organs · Nov 1999

    Pathophysiology of cardiac extracorporeal membrane oxygenation.

    • B P Fuhrman, L J Hernan, A T Rotta, C M Heard, and E R Rosenkranz.
    • State University of New York at Buffalo and Children's Hospital of Buffalo, 14222, USA.
    • Artif Organs. 1999 Nov 1;23(11):966-9.

    AbstractThe treatment of cardiogenic shock using inotropic agents and vascular volume expansion places an added burden on the heart. The resultant increase in cardiac work may cause myocardial ischemia and lead to cardiac arrest. Extracorporeal membrane oxygenation (ECMO) may be used to treat cardiogenic shock. It supports systemic circulation, assures diastolic perfusion of the myocardium, and reduces cardiac workload. The rise in blood pressure associated with restoring systemic circulation afterloads the heart and can cause left atrial hypertension and pulmonary edema. ECMO does not automatically reduce cardiac work, especially in the presence of residual shunts. Left atrial drainage or decompression may be essential in certain patients both to avert pulmonary edema and to reduce cardiac work.

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