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Intensive Care Medicine

, Volume 41, Issue 5, pp 902–905 | Cite as

How to wean a patient from veno-arterial extracorporeal membrane oxygenation

  • Nadia AissaouiEmail author
  • Aly El-Banayosy
  • Alain Combes
What's New in Intensive Care

Introduction

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can rescue patients with medical, postcardiotomy, or post-cardiac arrest refractory cardiogenic shock (CS) [1, 2]. It can be used as a bridge to cardiac transplantation, to a long-term ventricular assist device (VAD), or until recovery of myocardial function. Weaning success from VA-ECMO is defined as device removal and no further requirement for mechanical support because of recurring CS over the following 30 days [3]. However, to date, only very few studies have reported weaning strategies and outcomes in VA-ECMO patients recovering from severe CS.

Outcomes of patients receiving VA-ECMO

Rates of refractory CS patients who survive after VA-ECMO support vary from 31 to 76 %, depending on underlying causes of CS, comorbidities, and severity of organ dysfunction at ECMO initiation [4, 5, 6, 7, 8, 9]. In 81 patients who received VA-ECMO for various indications, our group showed that device insertion under cardiac...

Keywords

Cardiogenic Shock Levosimendan Ventricular Assist Device ECMO Support Myocardial Recovery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

CS

Cardiogenic shock

LVEF

Left ventricular ejection fraction

LV

Left ventricle

RV

Right ventricle

VA-ECMO

Veno-arterial extracorporeal membrane oxygenation

Notes

Conflicts of interest

The authors have no conflicts of interest to disclose.

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  1. 1.Service de Réanimation MédicaleHôpital Européen Georges Pompidou Assistance Publique-Hôpitaux de Paris and Université Paris Descartes ParisParisFrance
  2. 2.Division of Cardiology, Department of Medicine, Penn State College of Medicine, Heart and Vascular InstitutePenn State Milton S. Hershey Medical CenterHersheyUSA
  3. 3.Service de Réanimation Médicale, Hôpital Pitié-SalpêtrièreAssistance Publique-Hôpitaux de Paris and Université Pierre et Marie CurieParis 6France

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