Management of vascular complications of extra-corporeal membrane oxygenation

Abstract

Extra-corporeal membrane oxygenation (ECMO) is a well-established treatment for cardiopulmonary failure. Based on the requirement for cardiac and or respiratory support different configurations of ECMO circuits are utilized. Vascular complication of ECMO constitutes the most important determinant of treatment outcomes. The complications are primarily related to limb ischemia, vascular injury, hemorrhage, and infection. Endovascular and surgical treatment options are the cornerstone for managing vascular complications of ECMO.

Microcirculatory Response to Changes in Venoarterial Extracorporeal Membrane Oxygenation Pump Flow: A Prospective Observational Study

“…An inadequate low VA-ECMO pump flow leads to abnormal tissue perfusion and poor prognosis, and flow optimization is essential to maintaining adequate tissue and brain perfusion (4). In addition, high pump flow-related complications such as kidney injury, cerebral stroke, and hemorrhage are associated with high morbidity and mortality (5,6).…”

Should Physicians Offer a Ventricular Assist Device to a Pediatric Oncology Patient With a Poor Prognosis?

“…Unlike VADs, ECMO has typically been viewed as a short-term therapy for reversible processes or as a bridge to durable support. 23 Utilization of ECMO has resulted in ethical debates about autonomy, nonmaleficence, informed consent, resource allocation, and the advancement of medicine. 24,25 ECMO now has an expanded role including-at times-for patients with active malignancies who need short-term support to recovery, but this role can necessitate discussions of withdrawal of ECMO support if there is no clinical improvement.…”

Clinical complications during veno-arterial extracorporeal membrane oxigenation in post-cardiotomy and non post-cardiotomy shock: still the achille’s heel

“…Extracorporeal membrane oxygenation (ECMO) represents an established treatment for patients requiring temporary cardiopulmonary support (1)(2)(3)(4) who have failed the maximal conventional medical management (5).…”