How to wean a patient from veno-arterial extracorporeal membrane oxygenation
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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 . 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...
KeywordsCardiogenic Shock Levosimendan Ventricular Assist Device ECMO Support Myocardial Recovery
Left ventricular ejection fraction
Veno-arterial extracorporeal membrane oxygenation
Conflicts of interest
The authors have no conflicts of interest to disclose.
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