Despite the technological improvements of the last 40 years conditions such as refractory cardiogenic shock and cardiac arrest still present a very high mortality rate in the real-world clinical practice. In this light we have performed a review of the techniques, indications, contraindications and results of the so-called Veno-Arterial Extracorporeal Circulatory Membrane Oxygenation (VA-ECMO) in the adult population to evaluate the current results of this temporary cardio-pulmonary support as salvage and/or bridge therapy in patient suffering from refractory cardiogenic shock or cardio-circulatory arrest. The results are encouraging, especially in the setting of refractory cardiogenic shock and in-hospital cardiac arrest. Among a selected population the prompt institution of a VA-ECMO may radically change the prognosis by sustaining vital functions while looking for the leading cause or waiting for the reversal of the temporary cardio-respiratory negative condition. The future directions aim to standardized and shared protocols, miniaturization of the machines and possibly the institution of specialized "ECMO teams" for in and out-of-hospital institution of the tool.
Gennari M, L'Acqua C, Rubino M, Agrifoglio M, Salvi L, Ceriani R, Marenzi G, Marana I, Polvani G. Veno-Arterial Extracorporeal Membrane Oxygenation in the Adult: A Bridge to the State of the Art. Curr Cardiol Rev 2020 Nov 24. doi: 10.2174/1573403X16999201124202144