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ECMO Indications and Management

Critical care role of ECMO support in cardiogenic shock and refractory respiratory failure.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is ECMO Indications and Management?

Extracorporeal membrane oxygenation (ECMO) provides life-saving support in cardiogenic shock or severe respiratory failure unresponsive to conventional therapy.

VA-ECMO is preferred for cardiac support (cardiogenic shock, post-cardiotomy), VV-ECMO for severe ARDS. Initiation should occur in centres with sufficient experience following ELSO guidelines.

Symptoms

Refractory cardiogenic shock (high-dose inotrope despite SBP <90)
Cardiac arrest (ECPR; eCPR)
Severe ARDS (PaO2/FiO2 <80)
Severe air leak (refractory pneumothorax)
Bridge for transplant or VAD

Risk Factors

Multi-organ failure (>3 systems)
Active bleeding (CNS, GI)
Chronic kidney/liver failure
Advanced age (>75 years; relative contraindication)
Underlying malignancy (limited life expectancy)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Cardiogenic shock unresponsive to maximum medical therapy
  • Refractory hypoxaemia in severe ARDS
  • Cardiac arrest scenario suitable for ECPR
  • VAD/transplant bridge planning

Treatment Methods

01
VA-ECMO cannulation (femoral artery + femoral vein)
02
VV-ECMO cannulation (femoral vein + internal jugular)
03
Anticoagulation (unfractionated heparin; ACT 180-220)
04
Distal limb perfusion catheter (in femoral VA-ECMO)
05
LV unloading (Impella, IABP combination)
06
Daily SOFA score and lactate follow-up
07
Weaning protocol (decrease flow, target stable haemodynamics)
08
Infection surveillance (cannula site, blood culture)
09
Multidisciplinary team management (cardiology + intensive care + perfusion)

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.