Overview of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Support for the Management of Cardiogenic Shock

Adamantios Tsangaris; Tamas Alexy; Rajat Kalra; Marinos Kosmopoulos; Andrea Elliott; Jason A Bartos; Demetris Yannopoulos

doi:10.3389/fcvm.2021.686558

Overview of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Support for the Management of Cardiogenic Shock

Front Cardiovasc Med. 2021 Jul 7:8:686558. doi: 10.3389/fcvm.2021.686558. eCollection 2021.

Authors

Adamantios Tsangaris¹, Tamas Alexy¹, Rajat Kalra¹, Marinos Kosmopoulos², Andrea Elliott¹, Jason A Bartos^{1

2}, Demetris Yannopoulos^{1

2}

Affiliations

¹ Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, United States.
² Center for Resuscitation Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States.

Abstract

Cardiogenic shock accounts for ~100,000 annual hospital admissions in the United States. Despite improvements in medical management strategies, in-hospital mortality remains unacceptably high. Multiple mechanical circulatory support devices have been developed with the aim to provide hemodynamic support and to improve outcomes in this population. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is the most advanced temporary life support system that is unique in that it provides immediate and complete hemodynamic support as well as concomitant gas exchange. In this review, we discuss the fundamental concepts and hemodynamic aspects of VA-ECMO support in patients with cardiogenic shock of various etiologies. In addition, we review the common indications, contraindications and complications associated with VA-ECMO use.

Keywords: VA-ECMO complications; VA-ECMO indications; cardiogenic shock; extracorporeal membrane oxygenation; mechanical circulatory support.

Publication types

Review