The use of extracorporeal membrane oxygenation (ECMO) has experienced an exponential growth over the last 2 decades . Indications for ECMO include cardiogenic shock (CS), cardiac arrest, refractory ventricular arrhythmias, and pulmonary insufficiency. Veno-arterial ECMO (VA-ECMO) is specifically indicated for the treatment of CS secondary to acute myocardial infarction, myocarditis, chronic cardiomyopathy, septic cardiomyopathy, graft failure following heart transplantation, pulmonary embolism with right ventricular failure, and post-cardiotomy syndrome. VA-ECMO is frequently offered to CS patients as a last-resort treatment after other therapies have failed and they have progressed to advanced stages of shock. At the time of ECMO insertion, a significant proportion of these patients are in extremis, or they are undergoing cardiopulmonary resuscitation following cardiac arrest. Historically, VA-ECMO-related complications have been high, and survival outcomes have been imperfect. Furthermore, the use of this technology demands significant hospital resources and is associated with considerable financial cost.