Cardiogenic Shock: Evidence, Indications, and Exclusions

Abstract

Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) can support both gas exchange and the circulation, making it suitable for treatment of patients with cardiogenic shock, refractory cardiac arrest, acute right ventricular failure, and other causes of shock. VA-ECMO has several advantages over competing therapies. At the same time, the VA configuration introduces additional complexity and risk of complications when compared with venovenous ECMO. Advances in technology have improved the risk–benefit ratio, leading centers worldwide to consider VA-ECMO for patients at high risk of death from circulatory shock.