Comprehensive Hemodynamic Characterization and Clinical Implications of Venoarterial Extracorporeal Membrane Oxygenation (ECMO) in Cardiopulmonary Support-Review for ICU Professionals
Alammar, A., Al Mutairi, A., Al Mutairi, M., Al Harbi, N., Alduhami, A., Al-Yahya, S., Alhadlaq, F., ALSAEED, S., Alkhudhaur, A., Albaqami, F., Alharthi, S. (2025). Comprehensive Hemodynamic Characterization and Clinical Implications of Venoarterial Extracorporeal Membrane Oxygenation (ECMO) in Cardiopulmonary Support-Review for ICU Professionals. EKB Journal Management System, 7(3), 384-396. doi: 10.21608/jmals.2025.442788
Abdulrahman Nasser Alammar; Abdulelah Qalet Al Mutairi; Mohammad Nasser Al Mutairi; Naif Abdulaziz Al Harbi; Abdulrahman Sulaiman Alduhami; Saleh Abdulrahman Ali Al-Yahya; Faisal Abdulaziz A Alhadlaq; SAUD HAMAD ALSAEED; Abdulaziz Mohammed Abdullah Alkhudhaur; Faisal Abdullah Hader Albaqami; Shaden Saad Alharthi. "Comprehensive Hemodynamic Characterization and Clinical Implications of Venoarterial Extracorporeal Membrane Oxygenation (ECMO) in Cardiopulmonary Support-Review for ICU Professionals". EKB Journal Management System, 7, 3, 2025, 384-396. doi: 10.21608/jmals.2025.442788
Alammar, A., Al Mutairi, A., Al Mutairi, M., Al Harbi, N., Alduhami, A., Al-Yahya, S., Alhadlaq, F., ALSAEED, S., Alkhudhaur, A., Albaqami, F., Alharthi, S. (2025). 'Comprehensive Hemodynamic Characterization and Clinical Implications of Venoarterial Extracorporeal Membrane Oxygenation (ECMO) in Cardiopulmonary Support-Review for ICU Professionals', EKB Journal Management System, 7(3), pp. 384-396. doi: 10.21608/jmals.2025.442788
Alammar, A., Al Mutairi, A., Al Mutairi, M., Al Harbi, N., Alduhami, A., Al-Yahya, S., Alhadlaq, F., ALSAEED, S., Alkhudhaur, A., Albaqami, F., Alharthi, S. Comprehensive Hemodynamic Characterization and Clinical Implications of Venoarterial Extracorporeal Membrane Oxygenation (ECMO) in Cardiopulmonary Support-Review for ICU Professionals. EKB Journal Management System, 2025; 7(3): 384-396. doi: 10.21608/jmals.2025.442788

Comprehensive Hemodynamic Characterization and Clinical Implications of Venoarterial Extracorporeal Membrane Oxygenation (ECMO) in Cardiopulmonary Support-Review for ICU Professionals

Journal of Medical and Life Science
Volume 7, Issue 3, September 2025, Page 384-396  XML PDF (540.37 K)
Document Type: Original Article
DOI: 10.21608/jmals.2025.442788
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Authors
Abdulrahman Nasser Alammar email 1; Abdulelah Qalet Al Mutairi2; Mohammad Nasser Al Mutairi2; Naif Abdulaziz Al Harbi3; Abdulrahman Sulaiman Alduhami4; Saleh Abdulrahman Ali Al-Yahya2; Faisal Abdulaziz A Alhadlaq2; SAUD HAMAD ALSAEED2; Abdulaziz Mohammed Abdullah Alkhudhaur2; Faisal Abdullah Hader Albaqami2; Shaden Saad Alharthi5
1Master Quality and Patient Safety Improvement, Northern Area Armed Forces Hospital, SA
2Health Services Administration, Northern Area Armed Forces Hospital, SA
3Quality and Patient Safety department, Northern Area Armed Forces Hospital, SA
4Health Information Management, Qassim Armed Forces Hospital, SA
5Supply Department, Alkharj Armed Hospital, SA
Abstract
Background: Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for patients with refractory cardiac or respiratory failure. Since its introduction in 1972, ECMO has undergone significant advancements in circuit design, oxygenator efficiency, and monitoring systems, improving its safety and efficacy. Aim: This article provides a comprehensive review of venoarterial ECMO (VA ECMO), focusing on its hemodynamic effects, clinical applications, complications, and emerging innovations. Methods: The discussion examines ECMO circuit components (centrifugal pumps, oxygenators, cannulas), mechanics of blood extraction and reinfusion, gas exchange, and temperature regulation. It also explores clinical indications, contraindications, hemodynamic management, and complications such as oxygenator thrombosis, differential hypoxemia, and limb ischemia. Results: VA ECMO effectively supports cardiopulmonary function in cardiogenic shock, cardiac arrest, and severe hypoxemia. However, complications like left ventricular distention and thromboembolism require vigilant monitoring. Weaning protocols emphasize echocardiographic assessment and gradual flow reduction. Emerging techniques, such as percutaneous ventricular assist devices (e.g., Impella) and ambulatory ECMO, enhance cardiac unloading and patient mobility.
Conclusion: VA ECMO is a critical tool in managing severe cardiopulmonary failure; however, its success depends on multidisciplinary coordination, precise anticoagulation, and effective complication management. Technological advancements continue to improve outcomes, making ECMO a bridge to recovery or further intervention.
Keywords
ECMO; venoarterial; cardiogenic shock; hemodynamics; oxygenator; complications; weaning; mechanical circulatory support
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