Which therapy is unlikely to be utilized for a patient undergoing VA ECMO?

Beta-blockers are unlikely to be utilized for a patient undergoing VA ECMO because they can decrease heart rate and contractility, which may compromise cardiac output during a time when the heart is already struggling. VA ECMO is primarily used to support patients with severe cardiac failure, providing both oxygenation and cardiac support: while it takes over the role of the heart in pumping blood, the patient's underlying condition may require that cardiac output is maximized rather than reduced. In situations where the heart is failing, maintaining an appropriate heart rate and myocardial contractility is critical for ensuring adequate organ perfusion and oxygen delivery.

Conversely, inotropic support is frequently administered to enhance cardiac contractility and improve perfusion. Anticoagulation therapy is essential in VA ECMO to prevent thrombosis within the circuit. Invasive ventilation may be required if the patient also has respiratory failure, as it aids in oxygenation until recovery or more definitive surgical intervention can occur. Therefore, the administration of beta-blockers, which can hinder rather than help the function of the heart under such conditions, is not aligned with the management goals for patients on VA ECMO.