From the Guidelines
The main difference between Counterpulsation (CEC) and Extracorporeal Membrane Oxygenation (ECMO) lies in their duration and application, with CEC used for short-term support during cardiac surgeries and ECMO used for longer-term support in critically ill patients with severe cardiac and/or respiratory failure. The key differences between CEC and ECMO are:
- Duration of support: CEC is used for short-term support (hours) during cardiac surgeries, while ECMO is used for longer-term support (days to weeks) in critically ill patients.
- Application: CEC is used to provide complete cardiopulmonary bypass during cardiac surgeries, while ECMO is used to provide partial support to assist failing organs in critically ill patients.
- Configuration: ECMO can be configured as veno-arterial (VA-ECMO) for cardiac and respiratory support or veno-venous (VV-ECMO) for respiratory support only.
- Cannulation techniques: CEC typically uses central cannulation through the right atrium and aorta, while ECMO often employs peripheral cannulation through the femoral, jugular, or carotid vessels.
- Anticoagulation requirements: CEC requires full anticoagulation, while ECMO requires less anticoagulation. According to the most recent study 1, ECMO is increasingly used as a rescue therapy in patients with severe respiratory and/or cardiac failure, and understanding the complex interplay between ECMO and acquired von Willebrand syndrome is critical for healthcare professionals caring for patients supported by ECMO. Other studies 1 also highlight the differences between CEC and ECMO, including their indications, configurations, and outcomes. However, the most recent study 1 provides the most up-to-date information on the use of ECMO in critically ill patients.
From the Research
Overview of Counterpulsation (CEC) and Extracorporeal Membrane Oxygenation (ECMO)
There are no research papers provided to directly compare Counterpulsation (CEC) and Extracorporeal Membrane Oxygenation (ECMO). However, the following information is available on ECMO:
- ECMO is a form of life support that targets the heart and lungs 2
- It exists in two primary configurations: veno-venous ECMO for isolated respiratory failure and veno-arterial ECMO for cardiac failure 3
- ECMO provides days to weeks of support for patients with respiratory, cardiac, or combined cardiopulmonary failure 4
Indications for ECMO Use
The following are indications for ECMO use:
- Severe refractory cardiogenic shock
- Refractory ventricular arrhythmia
- Active cardiopulmonary resuscitation for cardiac arrest
- Acute or decompensated right heart failure 5
- Severe respiratory failure 6, 4
Key Aspects of ECMO Care
Key aspects of ECMO care include:
- Rigorous patient selection
- Careful attention to potential complications
- Seamless patient transport
- Clearly defined pathways for transition of care to centers capable of providing heart replacement therapies 5
- Multidisciplinary team of experts to guide institutional use of this therapy and the care of patients receiving it 5