Peripheral Veno-arterial Extracorporeal Membrane Oxygenation for Treatment of Ischemic Shock

Extracorporeal membrane oxygenation (ECMO), often referred to as extracorporeal life support (ECLS), provides temporary support to critically ill patients who cannot maintain their respiratory and/or circulatory function. A basic circuit composed of cannula, tubing, a pump, oxygenator, and heat exchanger; there are two approaches: veno-venous (VV) ECMO for solely respiratory support, and veno-arterial (VA) ECMO for cardiac support, cardio-respiratory support, or undifferentiated etiology support. Since first use in 1971 [1], ECMO circuits have improved in design and function [2-4]. This review focuses on contemporary insertion techniques and management considerations, which have improved clinical outcomes in VA ECMO, specifically, peripherally inserted VA ECMO for cardiogenic shock secondary to ischemic presentation.