Left Ventricular Rest and Unloading During VA ECMO

Greco, Guido; Cortinovis, Barbara; Avalli, Leonello

doi:10.1007/978-88-470-5427-1_17

Cited by 5 publications

(5 citation statements)

References 54 publications

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“…6 Detailed clinical assessment of LV overload may be cumbersome, since its biomechanical impact on the failing myocardium may not be well-represented by standard clinical diagnostics. 3,4,71,74,75 In general, repeated echocardiograms, assessment of intra-cardiac filling pressures and monitoring of pulmonary edema are imperative on a daily basis. Yet, the exact indication, timing and LV unloading strategy, i.e.…”

Section: Practical Implications For Clinical Decision Makingmentioning

confidence: 99%

Left ventricular unloading during veno-arterial ECMO: a review of percutaneous and surgical unloading interventions

et al. 2018

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Short-term mechanical support by veno-arterial extracorporeal membrane oxygenation (VA ECMO) is more and more applied in patients with severe cardiogenic shock. A major shortcoming of VA ECMO is its variable, but inherent increase of left ventricular (LV) mechanical load, which may aggravate pulmonary edema and hamper cardiac recovery. In order to mitigate these negative sequelae of VA ECMO, different adjunct LV unloading interventions have gained a broad interest in recent years. Here, we review the whole spectrum of percutaneous and surgical techniques combined with VA ECMO reported to date.

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Section: Practical Implications For Clinical Decision Makingmentioning

confidence: 99%

Left ventricular unloading during veno-arterial ECMO: a review of percutaneous and surgical unloading interventions

et al. 2018

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“…Determining how much flow is best to achieve optimal peripheral perfusion with some heart ejection remains unclear. Some have argued that allowing the supported heart to eject is better than full support in terms that it prevents the blood stasis as well as the dilatation [59][60][61]; however, as mentioned earlier, PC patients are different as the heart is already damaged so allowing the heart to eject might add extra workload [62].…”

Section: Flow Managementmentioning

confidence: 99%

Venoarterial Extracorporeal Membrane Oxygenation in Cardiac Surgery

Abdalghafoor¹,

Alwaheidi²,

Omar³

et al. 2023

Extracorporeal Membrane Oxygenation Support Therapy

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Owing to the growing demands of extracorporeal membrane oxygenation (ECMO)-designated support required for severe cardiac or respiratory failure, which is both potentially reversible and unresponsive to conventional management, novel ECMO indications emerge day after day. ECMO offers unique advantageous characteristics, which are compact pump-oxygenator design, percutaneous approach, flexible cannulae, and less inflammation making the modern venoarterial ECMO an ideal miniaturized cardiopulmonary bypass. We hereby discuss the background of ECMO success to backup complex high-risk cardiac surgical procedures.

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“…This imaging information can be derived on a daily basis and should allow individualization of the degree of extracorporeal support and also the need for adjuvant interventions to unload the left ventricle during VA ECLS, as reviewed recently. 6,7,24,51–53…”

Section: Echocardiographic Assessment During Veno-arterial Eclsmentioning

confidence: 99%

Echocardiography in extracorporeal life support: A key player in procedural guidance, tailoring and monitoring

et al. 2018

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Extracorporeal life support (ECLS) is a mainstay of current practice in severe respiratory, circulatory or cardiac failure refractory to conventional management. The inherent complexity of different ECLS modes and their influence on the native pulmonary and cardiovascular system require patient-specific tailoring to optimize outcome. Echocardiography plays a key role throughout the ECLS care, including patient selection, adequate placement of cannulas, monitoring, weaning and follow-up after decannulation. For this purpose, echocardiographers require specific ECLS-related knowledge and skills, which are outlined here.

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Left Ventricular Rest and Unloading During VA ECMO

Cited by 5 publications

References 54 publications

Left ventricular unloading during veno-arterial ECMO: a review of percutaneous and surgical unloading interventions

Left ventricular unloading during veno-arterial ECMO: a review of percutaneous and surgical unloading interventions

Venoarterial Extracorporeal Membrane Oxygenation in Cardiac Surgery

Echocardiography in extracorporeal life support: A key player in procedural guidance, tailoring and monitoring

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