The use of extra-corporeal membrane oxygenation post-cardiotomy: the
survival benefits
Abstract
Extra Corporeal Membrane Oxygenation (ECMO) is a supportive therapy used
to provide cardiac support with or without respiratory support in the
event of cardiopulmonary failure. The two main types of ECMO are
Veno-arterial ECMO (VA-ECMO) and Veno-venous ECMO (VV-ECMO). The use of
ECMO in cardiac surgery has been established in cases of post-cardiotomy
cardiogenic shock which is refractory to conventional therapy with
inotropes and intra-aortic balloon pulsation support. Survival for this,
otherwise, fatal condition has been shown to be improving through the
use of ECMO. However, the decision and timing to initiate ECMO therapy
remains selective and is dependent on a range of factors such as patient
factor, clinician’s judgement, meaning there is no consistent and solid
ground regarding the timing of ECMO initiation. This article will
provide an extensive review of ECMO indications, contraindications,
complications and outcomes to analyse the survival benefit of ECMO
following cardiac surgery.