ECMO provides mechanical cardiopulmonary support. It usually consists of a centrifugal pump, heat exchanger, and membrane oxygenator. Deoxygenated blood from a drainage cannula is propelled forward with a centrifugal pump, through an oxygenator, and back into the patient through a return cannula. There are two main configurations: veno-arterial (VA) and VV-ECMO. VA-ECMO (Figures 6.3 and 6.4) involves draining venous blood into the pump and returning it to the arterial circulation, which helps provide both circulatory and respiratory support. VV-ECMO (Figures 6.5 and 6.6) drains venous blood into the pump and returns oxygenated venous blood to the right atrium, providing only pulmonary support.

References

• ELSO Guidelines for Cardiopulmonary Extracorporeal Life Support Extracorporeal Life Support Organization, Version 1.4. Accessed May 14, 2023. www.elso.org
• Mazzeffi MA, Rao VK, Del Rio JM, et al. Intraoperative management of adult patients on extracorporeal membrane oxygenation: an expert consensus statement from the society of cardiovascular anesthesiologists—part I, technical aspects of extracorporeal membrane oxygenation. J Cardiothorac Vasc Anesth. 2021;35:3496-3512.