title: Veno-arterial extracorporeal membrane oxygenation: an overview of different cannulation techniques.
abstract: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has known a widespread application over the last decade and is now an effective and valuable therapeutic option in refractory cardiogenic shock of various etiologies. In this subgroup of critically ill and unstable patients in cardiogenic shock, VA-ECMO allows, on the one hand, temporary hemodynamic stabilization with improvement of end-organ function and, on the other hand, gives the time to perform complementary diagnostic exams and to decide the therapeutic strategy in these high-risk candidates for immediate long-term mechanical circulatory support (MCS) implantation. VA-ECMO could also be suggested as a rescue therapeutic option for refractory cardiac arrest. It showed promising results in the specific setting of in-hospital cardiac arrest and survival rates with good neurological outcome are reported between 20% and 40%. Conversely, there are contrasting data in the literature about survival after VA-ECMO for out-of-hospital cardiac arrest, as results are highly dependent on low-flow time. The aim of the present report is to offer an overview of different cannulation techniques of VA-ECMO.
authors.affiliation: Division of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland;; Faculty of Medicine, University of Geneva, Geneva, Switzerland;; Geneva Hemodynamic Research Group, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Carlo
authors.initials: C
authors.lastname: Banfi
authors.affiliation: Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, "Claude Bernard" University, Lyon, France.
authors.forename: Matteo
authors.initials: M
authors.lastname: Pozzi
authors.affiliation: Intensive Care Service, Department of Anesthesiology, Intensive Care and Pharmacology.
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Brunner
authors.affiliation: Division of Cardiology, Department of Medical Specialties, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Fabio
authors.initials: F
authors.lastname: Rigamonti
authors.affiliation: Division of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland;; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Murith
authors.affiliation: Division of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland;; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Damiano
authors.initials: D
authors.lastname: Mugnai
authors.affiliation: Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, "Claude Bernard" University, Lyon, France.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Obadia
authors.affiliation: Faculty of Medicine, University of Geneva, Geneva, Switzerland;; Geneva Hemodynamic Research Group, Faculty of Medicine, University of Geneva, Geneva, Switzerland ;; Intensive Care Service, Department of Anesthesiology, Intensive Care and Pharmacology.
authors.forename: Karim
authors.initials: K
authors.lastname: Bendjelid
authors.affiliation: Faculty of Medicine, University of Geneva, Geneva, Switzerland;; Geneva Hemodynamic Research Group, Faculty of Medicine, University of Geneva, Geneva, Switzerland ;; Intensive Care Service, Department of Anesthesiology, Intensive Care and Pharmacology.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Giraud
keywords: Cardiogenic shock; cardiac arrest; extracorporeal membrane oxygenation (ECMO)