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Extra-corporeal membrane oxygenation for the post-cardiotomy patient

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Abstract

Extra-corporeal membrane oxygenation remains the last resort in keeping patients alive in those with profound cardiogenic shock following percutaneous interventions or open surgery on the heart. No guidelines exist on the management of patients on such a device despite a high mortality. We attempt to highlight some universal principles that would be relevant to the current practice of those exposed to this challenging field.

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Abbreviations

AVR:

Aortic valve replacement

Bi-VAD:

Bi-ventricular assist device

CABG:

Coronary artery bypass grafting

ECMO:

Extra-corporeal membrane oxygenation

HIT:

Heparin-induced thrombocytopenia

LVAD:

Left ventricular assist device

RVAD:

Right ventricular assist device

VA:

Veno-arterial

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Acknowledgments

We would like to thank Mr. Thasee Pillay, Consultant Cardiothoracic Transplant Surgeon and Clinical Director of the cardiothoracic service at the Freeman hospital in Newcastle in the UK for his advice with the manuscript. We would also like to thank Peter Gardiner from Clinical Skills Ltd for his illustration of the ECMO circuit.

Conflict of interest

The authors have no conflict of interests to disclose. The authors have no financial ties to disclose

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Authors and Affiliations

  1. Department of Cardiac Surgery, Castle Hill Hospital, Cottingham, HU16 5JQ, UK

    Priyadharshanan Ariyaratnam, Lindsay A. McLean, Alexander R. J. Cale & Mahmoud Loubani

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  1. Priyadharshanan Ariyaratnam
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  2. Lindsay A. McLean
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  3. Alexander R. J. Cale
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  4. Mahmoud Loubani
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Correspondence to Priyadharshanan Ariyaratnam.

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Ariyaratnam, P., McLean, L.A., Cale, A.R.J. et al. Extra-corporeal membrane oxygenation for the post-cardiotomy patient. Heart Fail Rev 19, 717–725 (2014). https://doi.org/10.1007/s10741-014-9428-9

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