Extracorporeal Membrane Oxygenation: Beyond Conventional Indications

Abstract

Over the last several years, the use of extracorporeal membrane oxygenation (ECMO) has exponentially increased. As the technology advanced, the rate of devastating complications has decreased somewhat, and the utility of ECMO has expanded beyond its conventional uses in cardiogenic shock and acute respiratory distress syndrome (ARDS). Currently, ECMO can be deployed in the perioperative period with high-risk surgeries where cardiac or respiratory compromise is anticipated. Moreover, it can be utilized in difficult airway patients or patients undergoing airway surgeries, thoracic surgery patients, trauma victims and many other conditions previously excluded. The aim of this review is to highlight the ECMO-patient interaction, the indications for ECMO in the non-cardiac surgery population, ECMO management and potential complications.

The impact of acute kidney injury stages on the outcomes of veno‐arterial extracorporeal membrane oxygenation

“…V-A ECMO is indicated in refractory cardiogenic shock due to acute heart failure, myocardial infarction, viral myocarditis, post-cardiotomy shock, malignant ventricular arrhythmia, cardiotoxin overdose, and cardiorespiratory arrest, among many other indications. 1 In addition, the recent change in the United Network for Organ Sharing donor allocation system prioritizes patients on ECMO for heart transplantation. 2 The expansion of V-A ECMO use contributed significantly to the increase of its utilization worldwide.…”

“…Veno‐arterial (V‐A) extracorporeal membrane oxygenation (ECMO) provides biventricular and respiratory support in patients suffering from cardiogenic shock due to various etiologies. V‐A ECMO is indicated in refractory cardiogenic shock due to acute heart failure, myocardial infarction, viral myocarditis, post‐cardiotomy shock, malignant ventricular arrhythmia, cardiotoxin overdose, and cardiorespiratory arrest, among many other indications 1 . In addition, the recent change in the United Network for Organ Sharing donor allocation system prioritizes patients on ECMO for heart transplantation 2 .…”