Extracorporeal Membrane Oxygenation and Short-Term Mechanical Circulatory Support

Alfred Casillan, MD, PhD, Trevor A. Ellison, MD, PhD, Ahmet Kilic, MD, Chun W. Choi, MD, Errol L Bush, MD, FACS

Key Points

  • Venoarterial extracorporeal membrane oxygenation (ECMO) supports both the heart and lungs by providing gas exchange and systemic perfusion, and it is indicated in cases of refractory cardiogenic shock.
  • Extracorporeal cardiopulmonary resuscitation (eCPR) involves the application of VA ECMO during cardiac arrest or, more specifically, prior to the return of spontaneous circulation.
  • Venovenous ECMO is used primarily for respiratory failure/support, and it should only be utilized if there is sufficient cardiac function.
  • ECMO plays an important role in managing the most advanced cases of COVID-19 that are refractory to conventional interventions.
  • Hybrid and parallel ECMO configurations are considered for selected circumstances in which a single ECMO circuit is inadequate.
  • Short-term mechanical circulatory support devices (MCSD) are temporary percutaneously-inserted devices that can be deployed for refractory cardiogenic shock.

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Last updated: May 17, 2023