Emerging concepts in heart failure management and treatment: circulatory support with extracorporeal membrane oxygenation (ECMO)

Abstract

Circulatory support with extracorporeal membrane oxygenation (ECMO) is being increasingly used in several critical situations but evidence of its impact on outcomes is inconsistent. Understanding of the specific indications and appropriate timing of implantation of this technology might lead to improved results. Indeed, the line between success and futility may be sometimes very thin when facing a patient in critical condition. New techniques with lighter, simpler and effective devices are being developed. Hence, ECMO has become an accessible technology that is being increasingly used outside of the operating room by heart failure specialists, critical care cardiologists and intensivists. Proper timing of utilization and choice of device may lead to better outcomes. We herein aim to improve this knowledge gap by conducting a literature review to provide simple information, evidence-based indications and a practical approach for cardiologists who may encounter acutely ill adult patients that may be ECMO candidates. This article is part of the Emerging concepts in heart failure management and treatment Special Issue: https://www.drugsincontext.com/special_issues/emerging-concepts-in-heart-failure-management-and-treatment

Multimodality Imaging in Advanced Heart Failure for Diagnosis, Management and Follow-Up: A Comprehensive Review

“…The veno-arterial extracorporeal membrane oxygenation (V-A ECMO) system is a percutaneous system that takes over the heart and lungs. It consists of a system of inflow and outflow cannulas, a centrifugal pump, and an oxygenating membrane [66]. The ECMO provides a blood flow rate greater than 4.5 L. The effect is a noticeable reduction in LV preload increasing the afterload [67].…”