• Circ Heart Fail · Sep 2018

    Review

    Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest.

    • Prashant Rao, Zain Khalpey, Richard Smith, Daniel Burkhoff, and Robb D Kociol.
    • Sarver Heart Center, University of Arizona, Tucson (P.R.).
    • Circ Heart Fail. 2018 Sep 1; 11 (9): e004905.

    AbstractVenoarterial extracorporeal membrane oxygenation (VA-ECMO)-also referred to as extracorporeal life support-is a form of temporary mechanical circulatory support and simultaneous extracorporeal gas exchange. The initiation of VA-ECMO has emerged as a salvage intervention in patients with cardiogenic shock, even cardiac arrest refractory to standard therapies. Analogous to veno-venous ECMO for acute respiratory failure, VA-ECMO provides circulatory support and allows time for other treatments to promote recovery or may be a bridge to a more durable mechanical solution in the setting of acute or acute on chronic cardiopulmonary failure. In this review, we provide a brief overview of VA-ECMO, the attendant physiological considerations of peripheral VA-ECMO, and its complications, namely that of left ventricular distention, bleeding, heightened systemic inflammatory response syndrome, thrombosis and thromboembolism, and extremity ischemia or necrosis.

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