Veno-Arterial Extracorporeal Membrane Oxygenation in the Adult: A Bridge to the State of the Art |
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Authors: | Marco Gennari Camilla LAcqua Mara Rubino Marco Agrifoglio Luca Salvi Roberto Ceriani Giancarlo Marenzi Ivana Marana Gianluca Polvani |
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Institution: | 1. IRCCS Centro Cardiologico Monzino, Milan, Italy; 2.Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy; 3.Department of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy |
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Abstract: | Despite the technological advancements in the last 40 years, conditions such as refractory cardiogenic shock and cardiac arrest still present a very high mortality rate in real-world clinical practice.In this light, we have reviewed 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 the 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 the out-of-hospital institution of the tool. |
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Keywords: | ECMO ECLS cardiogenic shock cardiac arrest myocarditis cardio-pulmonary support |
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