VA ECMO for postcardiotomy cardiogenic shock in adults

Extracorporeal membrane oxygenation (ECMO) can be used to manage postcardiotomy cardiogenic shock immediately after heart surgery, or to help separation from cardiopulmonary bypass.

In venoarterial ECMO, blood is taken from the venous system (usually from the femoral vein or the right atrium) and pumped through an oxygenator, where oxygen and carbon dioxide are exchanged. It is then returned to the arterial system (usually through the femoral or axillary artery or ascending aorta). People are given a continuous infusion of an anticoagulant, usually heparin, to prevent blood clotting in the extracorporeal system. For people with poor kidney function, a haemofiltration unit may be added to the circuit.