Mechanical Circulatory Support study guide previews.

ECMO is a form of temporary extracorporeal life support for patients with refractory cardiac and/or respiratory failure who are expected to die without advanced support. Used when lungs and/or heart cannot sustain life, despite maximal conventional therapy. Oxygenated blood is returned back to right atrium / IVC. Key Insight includes blood entering the right heart is already oxygenated - the lungs become largely bypassed functionally, though blood still traverses them.

Or to decision in cardiogenic shock / refractory ischemia. Key concepts include Inserted into the descending thoracic aorta, Inflates in diastole leading to boosts aortic diastolic pressure, and Deflates just before systole leading to reduces LV afterload. Inserted via 8 Fr sheath into include Femoral artery leading to iliac artery leading to descending aorta leading to up towards the aortic arch. Distal tip should sit include ~1 cm distal to the left subclavian artery origin.

This positioning include Ensures balloon inflates in the descending thoracic aorta. Systolic downstroke leading to declining pressure as ejection tapers. Diastolic runoff leading to gradual fall in pressure. The balloon include Immediately after aortic valve closure (at/just after dicrotic notch) and Just before aortic valve opens, at the end of diastole.

Key physiology pearl include VA-ECMO increases afterload, which can worsen LV distension and pulmonary edema if unloading is not addressed. These represent typical starting ranges for conceptual understanding - actual settings depend on patient size, cannula size, and institutional protocol.

VV-ECMO introduces the clinical pattern, physiology, and bedside decisions that matter for emergency and critical care practice.