REVIEWIs venoarterial extracorporeal membrane oxygenation an option for managing septic shockHelwani, Mohammad A.a; Lim, Aaronb Author Information aWashington University, Department of Anesthesiology, St. Louis, Missouri bVirginia Commonwealth University, Richmond, Virginia, USA Correspondence to Mohammad A. Helwani, MD, MSPH, Department of Anesthesiology, Associate Professor of Anesthesiology and Cardiothoracic Surgery, Washington University in St. Louis, School of Medicine, 660 South Euclid Ave. Campus Box 8054, St. Louis, MO 63110, USA. Tel: +1 314 662 4069; fax: +1 314 747 3977; e-mail: [email protected] Current Opinion in Anaesthesiology: November 16, 2022 - Volume - Issue - 10.1097/ACO.0000000000001206 doi: 10.1097/ACO.0000000000001206 Buy PAP Metrics Abstract Purpose of review To describe sepsis-induced cardiomyopathy. Discuss indications and current evidence of using venoarterial extracorporeal membrane oxygenation (VA-ECMO) in setting of sepsis-induced cardiomyopathy. Recent findings Recent data suggests a survival benefit with the use of VA-ECMO in patients with septic shock complicated by septic-induced cardiomyopathy with severe left ventricular systolic dysfunction. VA-ECMO was associated with poor outcomes in adults with septic shock without severe systolic dysfunction. The evidence is generated from retrospective and meta-analysis of observational studies. Summary Sepsis-induced cardiomyopathy is an increasingly recognized entity characterized by reversible ventricular dysfunction in the setting of sepsis. When hypotension persists despite standard management of septic shock (e.g. adequate fluid resuscitation, vasopressors, inotropes) and there is evidence of severe cardiac systolic dysfunction and end-organ hypoperfusion, VA-ECMO should be considered as a bridge therapy to recovery. VA-ECMO should not be used for isolated vasodilatory septic shock without significant myocardial dysfunction. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.