Extracorporeal Membrane Oxygenation Support for Post- Cardiotomy Cardiogenic Shock

Abstract

Cardiogenic shock following cardiac surgery is rare, but a serious complication. Patients who suffer from severe valvular disease, low cardiac function, massive myocardial infarction, and acute aortic dissection have high risk of cardiogenic shock after surgery. Extracorporeal membrane oxygenation (ECMO) is a last resort treatment option for such patients. However, ethical concerns exist regarding whether ECMO is worthwhile for them, because it carries a huge financial burden, and the mortality of ECMO patients following cardiac surgery is reported to be as high as 60-80%. No guideline exists regarding optimal patient selection, duration of mechanical support, and management of ECMO. There are many unanswered questions in this field. This is a comprehensive review regarding the most recent available evidences in the field of ECMO support for post-cardiotomy cardiogenic shock.