Venoarterial ECMO for Adults: JACC Scientific Expert Panel

Maya Guglin, Mark J. Zucker, Vanessa M. Bazan, Biykem Bozkurt, Aly El Banayosy, Jerry D. Estep, John Gurley, Karl Nelson, Rajasekhar Malyala, Gurusher S. Panjrath, Joseph B. Zwischenberger, Sean P. Pinney

Research output: Contribution to journalReview articlepeer-review

265 Scopus citations


Venoarterial extracorporeal membrane oxygenation (ECMO) is a rescue therapy that can stabilize patients with hemodynamic compromise, with or without respiratory failure, for days or weeks. In cardiology, the main indications for ECMO include cardiac arrest, cardiogenic shock, post-cardiotomy shock, refractory ventricular tachycardia, and acute management of complications of invasive procedures. The fundamental premise underlying ECMO is that it is a bridge—to recovery, to a more durable bridge, to definitive treatment, or to decision. As a very resource- and effort-intensive intervention, ECMO should not be used on unsalvageable patients. As the use of this technology continues to evolve rapidly, it is important to understand the indications and contraindications; the logistics of ECMO initiation, management, and weaning; the general infrastructure of the program (including the challenges associated with transferring patients supported by ECMO); and ethical considerations, areas of uncertainty, and future directions.

Original languageEnglish
Pages (from-to)698-716
Number of pages19
JournalJournal of the American College of Cardiology
Issue number6
StatePublished - Feb 19 2019

Bibliographical note

Publisher Copyright:
© 2019 American College of Cardiology Foundation


  • ECLS
  • cardiac arrest
  • cardiogenic shock

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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