In a Patient Under ECMO

Abstract

The assessment of hemodynamic status and the choice of hemodynamic therapy in patients with severe cardiopulmonary failure supported with extracorporeal membrane oxygenation (ECMO) are affected by many factors. Because blood is drained from and reinfused into the venous system, venovenous ECMO does not directly provide any hemodynamic support. In contrast, venoarterial ECMO reinfuses blood directly into an artery, thereby providing circulatory support by pumping blood directly into the systemic circulation. Thus, hemodynamic management of venovenous and venoarterial ECMO may differ. This chapter summarizes the key points for clinicians regarding the specific management of patients with refractory acute respiratory distress syndrome on venovenous ECMO and those with refractory cardiogenic shock supported by venoarterial ECMO.