Premium
Pathophysiology of Cardiac Extracorporeal Membrane Oxygenation
Author(s) -
Fuhrman Bradley P.,
Hernan Lynn J.,
Rotta Alexandre T.,
Heard Christopher M.B.,
Rosenkranz Eliot R.
Publication year - 1999
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1046/j.1525-1594.1999.06484.x
Subject(s) - cardiogenic shock , medicine , cardiology , extracorporeal membrane oxygenation , inotrope , cardiac output , extracorporeal circulation , heart failure , pulmonary edema , shock (circulatory) , cardiac tamponade , anesthesia , myocardial infarction , hemodynamics , lung
The treatment of cardiogenic shock using inotropic agents and vascular volume expansion places an added burden on the heart. The resultant increase in cardiac work may cause myocardial ischemia and lead to cardiac arrest. Extracorporeal membrane oxygenation (ECMO) may be used to treat cardiogenic shock. It supports systemic circulation, assures diastolic perfusion of the myocardium, and reduces cardiac workload. The rise in blood pressure associated with restoring systemic circulation afterloads the heart and can cause left atrial hypertension and pulmonary edema. ECMO does not automatically reduce cardiac work, especially in the presence of residual shunts. Left atrial drainage or decompression may be essential in certain patients both to avert pulmonary edema and to reduce cardiac work.