PMID- 31116109
OWN - NLM
STAT- MEDLINE
DCOM- 20200327
LR  - 20200327
IS  - 1531-7072 (Electronic)
IS  - 1070-5295 (Linking)
VI  - 25
IP  - 4
DP  - 2019 Aug
TI  - Venoarterial extracorporeal membrane oxygenation in cardiogenic shock: 
      indications, mode of operation, and current evidence.
PG  - 397-402
LID - 10.1097/MCC.0000000000000627 [doi]
AB  - PURPOSE OF REVIEW: Temporary circulatory support (TCS) with venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO) is increasingly used as a salvage 
      therapy for patients with refractory cardiogenic shock. This article provides an 
      overview of VA-ECMO principles, indications, management, complications, and 
      discusses the results of recent case series and trials. RECENT FINDINGS: VA-ECMO 
      is utilized as a bridge to 'decision' that includes weaning after cardiac 
      function recovery, transplantation, long-term mechanical circulatory support, and 
      withdrawal in case of futility. VA-ECMO is considered the first-line TCS as it 
      allows rapid improvement in oxygenation, is less expensive, and is also suitable 
      for patients with biventricular failure. Combining Impella (Abiomed, Danvers, MA, 
      USA) or intra-aortic balloon pump support with VA-ECMO might decrease left 
      ventricular pressure and improve outcomes. Massive pulmonary embolism, 
      sepsis-associated cardiomyopathy, and refractory cardiac arrest are among 
      emerging indications for TCS. SUMMARY: TCS have become the cornerstone of the 
      management of patients with cardiogenic shock, although the evidence supporting 
      their efficacy is limited. VA-ECMO is considered the first-line option, with a 
      growing number of accepted and emerging indications. Randomized clinical trials 
      are now needed to determine the place VA-ECMO in cardiogenic shock treatment 
      strategies.
FAU - Pineton de Chambrun, Marc
AU  - Pineton de Chambrun M
AD  - Service de medecine intensive-reanimation, Institut de Cardiologie, APHP Hopital 
      Pitie-Salpetriere.
AD  - Sorbonne Universite, INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and 
      Nutrition, Paris, France.
FAU - Brechot, Nicolas
AU  - Brechot N
AD  - Service de medecine intensive-reanimation, Institut de Cardiologie, APHP Hopital 
      Pitie-Salpetriere.
AD  - Sorbonne Universite, INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and 
      Nutrition, Paris, France.
FAU - Combes, Alain
AU  - Combes A
AD  - Service de medecine intensive-reanimation, Institut de Cardiologie, APHP Hopital 
      Pitie-Salpetriere.
AD  - Sorbonne Universite, INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and 
      Nutrition, Paris, France.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Crit Care
JT  - Current opinion in critical care
JID - 9504454
SB  - IM
MH  - *Extracorporeal Membrane Oxygenation
MH  - Humans
MH  - Shock, Cardiogenic/*therapy
EDAT- 2019/05/23 06:00
MHDA- 2020/03/28 06:00
CRDT- 2019/05/23 06:00
PHST- 2019/05/23 06:00 [pubmed]
PHST- 2020/03/28 06:00 [medline]
PHST- 2019/05/23 06:00 [entrez]
AID - 10.1097/MCC.0000000000000627 [doi]
PST - ppublish
SO  - Curr Opin Crit Care. 2019 Aug;25(4):397-402. doi: 10.1097/MCC.0000000000000627.