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Veno-Arterial Extracorporeal Membrane Oxygenation in the Adult: A Bridge to the State of the Art

Author(s):

Marco Gennari*, Camilla L’Acqua, Mara Rubino, Marco Agrifoglio, Luca Salvi, Roberto Ceriani, Giancarlo Marenzi, Ivana Marana and Gianluca Polvani   Pages 1 - 7 ( 7 )

Abstract:


Despite the technological improvements of the last 40 years conditions such as refractory cardiogenic shock and cardiac arrest still present a very high mortality rate in the real-world clinical practice.

In this light we have performed a review of the techniques, indications, contraindications and results of the so-called Veno-Arterial Extracorporeal Circulatory Membrane Oxygenation (VA-ECMO) in the adult population to evaluate the current results of this temporary cardio-pulmonary support as salvage and/or bridge therapy in patient suffering from refractory cardiogenic shock or cardio-circulatory arrest.

The results are encouraging, especially in the setting of refractory cardiogenic shock and in-hospital cardiac arrest. Among a selected population the prompt institution of a VA-ECMO may radically change the prognosis by sustaining vital functions while looking for the leading cause or waiting for the reversal of the temporary cardio-respiratory negative condition.

The future directions aim to standardized and shared protocols, miniaturization of the machines and possibly the institution of specialized “ECMO teams” for in and out-of-hospital institution of the tool.

Keywords:

ECMO, ECLS, cardiogenic shock, cardiac arrest, myocarditis

Affiliation:

IRCCS Centro Cardiologico Monzino, Milan,, IRCCS Centro Cardiologico Monzino, Milan,, IRCCS Centro Cardiologico Monzino, Milan,, Department of Biomedical Surgical and Dental Sciences, University of Milan,, IRCCS Centro Cardiologico Monzino, Milan,, IRCCS Centro Cardiologico Monzino, Milan,, IRCCS Centro Cardiologico Monzino, Milan,, IRCCS Centro Cardiologico Monzino, Milan,, Department of Cardiovascular Sciences and Community Health, University of Milan



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