Extracorporeal Membrane Oxygenation (VA-ECMO) in Management of Cardiogenic Shock

Klaudia J. Koziol, Ameesh Isath, Shiavax Rao, Vasiliki Gregory, Suguru Ohira, Sean Van Diepen, Roberto Lorusso, Chayakrit Krittanawong*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Cardiogenic shock is a critical condition of low cardiac output resulting in insufficient systemic perfusion and end-organ dysfunction. Though significant advances have been achieved in reperfusion therapy and mechanical circulatory support, cardiogenic shock continues to be a life-threatening condition associated with a high rate of complications and excessively high patient mortality, reported to be between 35% and 50%. Extracorporeal membrane oxygenation can provide full cardiopulmonary support, has been increasingly used in the last two decades, and can be used to restore systemic end-organ hypoperfusion. However, a paucity of randomized controlled trials in combination with high complication and mortality rates suggest the need for more research to better define its efficacy, safety, and optimal patient selection. In this review, we provide an updated review on VA-ECMO, with an emphasis on its application in cardiogenic shock, including indications and contraindications, expected hemodynamic and echocardiographic findings, recommendations for weaning, complications, and outcomes. Furthermore, specific emphasis will be devoted to the two published randomized controlled trials recently presented in this setting.
Original languageEnglish
Article number5576
Number of pages19
JournalJournal of Clinical Medicine
Volume12
Issue number17
DOIs
Publication statusPublished - 1 Sept 2023

Keywords

  • extracorporeal membrane oxygenation (ECMO)
  • venoarterial
  • cardiogenic shock (CS)
  • mechanical circulatory support (MCS)
  • left ventricle (LV)
  • HOSPITAL CARDIAC-ARREST
  • CONVENTIONAL CARDIOPULMONARY-RESUSCITATION
  • LIFE-SUPPORT
  • VASCULAR COMPLICATIONS
  • CIRCULATORY SUPPORT
  • VENOARTERIAL ECMO
  • SHORT-TERM
  • ECHOCARDIOGRAPHY
  • ADULTS
  • RATIONALE

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