Extracorporeal Membrane Oxygenation in Cardiothoracic Surgery: Indications, Management, and Outcomes

Extracorporeal membrane oxygenation (ECMO) has emerged as a critical rescue and support modality across a widening spectrum of cardiothoracic surgical and critical care scenarios. This chapter reviews the physiological principles underlying venoarterial and venovenous ECMO, the evidence base for its application in refractory cardiogenic shock, post-cardiotomy failure, primary graft dysfunction following transplantation, and as a bridge to definitive therapy. Contemporary cannulation strategies, circuit management, weaning protocols, and complications — including neurological, hemorrhagic, and limb ischemia events — are discussed alongside outcome data from high-volume centers.