How I Approach Weaning from Venoarterial Ecmo

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a temporary mechanical circulatory support device capable of providing robust cardiopulmonary support for days to weeks, most commonly in the setting of refractory cardiogenic shock or cardiac arrest as a bridge to recovery or heart replacement therapies (HRT, e.g., durable left ventricular assist device or cardiac transplantation). Given the complications associated with prolonged use of VA-ECMO, it is imperative to institute systematic weaning strategies. In this article, we review our standardized approach to VA-ECMO weaning in adult patients.