ECMO in Cardiogenic Shock as Bridge to Decision: Candidate Selection, Implementation and Exit Strategies

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In this video, Christian Bermudez, MD, reviews extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation (LTX). Beginning with advances in cannula design and other technologies that have simplified and expedited the use of ECMO, Dr. Bermudez examines the distinctions between veno-arterial (VA) and veno-venous (VV) ECMO, and the factors that have defined, improved and altered the use of both approaches as a bridge to LTX. These include the implementation of decision algorithms for bridge to LTX, better definition of the criteria for patient selection, a greater comprehension of the post-operative course and complications of ECMO in lung transplantation (including graft dysfunction) and the value of rehabilitation during and after ECMO. Dr. Bermudez ends his discussion with a review of ECMO as bridge to transplant at Penn Medicine.