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Veno-arterial-ECMO in the intensive care unit: From technical aspects to clinical practice
Arthur Le Gall1, Arnaud Follin2, Bernard Cholley2
1Anaesthesiology and Intensive Care Department, European Hospital Georges-Pompidou, Paris, 75015 France; INRIA Paris-Saclay University, 91120 Palaiseau, France; LMS, Paris-Saclay University, 91120 Palaiseau, France.
Abstract:
The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasising the need for selecting the right indication in the right patient. This relies upon a clear definition of the individual therapeutic project, including the potential for recovery as well as the possible complications associated with VA-ECMO. To maximise the benefits of VA-ECMO, the basics of extracorporeal circulation should be perfectly understood since VA-ECMO can sometimes be detrimental. Hence, to be successful, VA-ECMO should be used by teams with sufficient experience and initiated after a thorough multidisciplinary discussion considering patient's medical history, pathology as well the anticipated evolution of the disease.