Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a powerful hemodynamic support strategy for patients with cardiogenic shock and out-of-hospital cardiac arrest (OHCA). 

Given that significant proportions of patients presenting with cardiogenic shock and refractory OHCA exhibit critical underlying coronary disease, 

VA-ECMO provides the stability necessary for revascularization and, therefore, treatment of the underlying aetiology of the arrest. The ongoing cardiopulmonary support then mitigates risk of rearrest and supports recovery of end-organ function while minimizing the harmful effects of vasopressors and ventilator support.