The Anesthetic Management of a Patient on VA ECMO Undergoing a Hemicolectomy

Veno-Arterial extracorporeal (VA ECMO) provides temporary mechanical support to the patient with cardiac and/or respiratory failure in cases of cardiogenic shock or heart failure [1-3]. VA ECMO essentially decreases cardiac work and reduces oxygen consumption while providing sufficient organ perfusion. ECMO is a bridge to recovery, left ventricular assist device (LVAD) implantation or eventual cardiac transplantation. ECMO requires continuous systemic heparin anticoagulation otherwise thrombosis can occur in the oxygenator and circuit leading to devastating complications including embolism and death.