Veno-arterial-ECMO in the Intensive Care Unit: From Technical Aspects to Clinical Practice

Anaesth Crit Care Pain Med. 2018 Jun;37(3):259-268. doi: 10.1016/j.accpm.2017.08.007. Epub 2017 Oct 13.

Abstract

The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasising the need for selecting the right indication in the right patient. This relies upon a clear definition of the individual therapeutic project, including the potential for recovery as well as the possible complications associated with VA-ECMO. To maximise the benefits of VA-ECMO, the basics of extracorporeal circulation should be perfectly understood since VA-ECMO can sometimes be detrimental. Hence, to be successful, VA-ECMO should be used by teams with sufficient experience and initiated after a thorough multidisciplinary discussion considering patient's medical history, pathology as well the anticipated evolution of the disease.

Keywords: ECLS; ECMO; Extracorporeal circulation; Extracorporeal life support; Extracorporeal membrane oxygenation; Intensive care unit.

Publication types

  • Review

MeSH terms

  • Critical Care / methods*
  • Extracorporeal Membrane Oxygenation / methods*
  • Extracorporeal Membrane Oxygenation / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data*