Table 1.

Key Differences between Venoarterial and Venovenous Extracorporeal Membrane Oxygenation in the Steady State

	VA-ECMO	VV-ECMO
Flow characteristics	Nonpulsatile	Nonpulsatile
	No recirculation	Recirculation*
Direct hemodynamic support	Partial to complete	None
LV effects	Decreased preload	None
	Increased afterload	None
Coronary oxygenation	Native ejection (patient)	Increased
RV effects	Decreased preload	None†
	Decreased afterload	None†
Pulmonary	Gas exchange	Gas exchange
	Decreased pulmonary blood flow	Unchanged

Definition of abbreviations: ECMO = extracorporeal membrane oxygenation; LV = left ventricle; RV = right ventricle; VA = venoarterial; VV = venovenous.

^*Oxygenated perfusate blood mixed with venous blood, reinfused back into the extracorporeal circuit.

^†May have subtle effects on RV function via reversal of hypoxic pulmonary vasoconstriction, limiting positive intrathoracic pressure, and augmenting coronary oxygenation.