Veno-arterial extracorporeal membrane oxygenation (VA ECMO) application in adult patients has significantly increased in recent years.

The Extracorporeal Life Support Organization (ELSO) registry includes more than 39,000 adult patients receiving VA ECMO support over the last 5 years.

Accepted indications for VA ECMO support include cardiogenic shock secondary to acute myocardial infarction, myocarditis, septic cardiomyopathy, cardiotoxic drug intoxications, cardiac arrest, post-cardiotomy shock, post heart transplant or LVAD implant, postpartum cardiomyopathy, end-stage dilated cardiomyopathy, and acute pulmonary embolism.

VA-ECMO support can be initiated through peripheral cannulation (most commonly) or central cannulation.

All VA ECMO patients ideally should be managed in a specialized mechanical circulatory support intensive care unit (ICU) or cardiothoracic ICU with extensive experience in caring for these extremely complicated and challenging patients.

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