Cardiac protection and management during extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) is actually a life-saving treatment in severe cardiac and/or pulmonary insufficiency, and it is becoming increasingly popular as a supportive strategy up to the cure of the underlying cardiopulmonary pathologies, a bridging therapy up to organ transplantation, or a salvage therapy up to the recovery of failed organ or system. In addition, its use in noncardiac patients with various indications and pathologies are spreading worldwide thanks to many different devices and application approaches in practice, providing ease of use with standardized application methods. Despite its advantages, the benefits may be limited as it has no apparent and direct effect in reversing pathophysiological processes or it may worsen the course of diseases due to its inherent side effects. In addition, the use of ECMO in patients with noncardiac disease can be a life-saving treatment option, and patients can survive until the failed noncardiac organs heal; however, it may create varying degrees of myocardial dysfunction over time. In this chapter, the diagnosis and treatment options of circulatory collapse that develops for various reasons and also the cardiac salvage or rescue therapies through ECMO approaches are discussed in detail.