REMAP ECMO - Beta Receptor Modulation Trial

This trial is testing whether a short-acting beta-blocker medication (esmolol) can improve outcomes in critically ill patients on a type of heart-lung bypass machine called VA-ECMO (used when the heart is failing severely), compared to standard care. **You may be eligible if...** - You are 18 or older - You are on VA-ECMO for severe heart failure involving the left or both ventricles - You were started on VA-ECMO within the past 16 hours - You are receiving certain levels of heart support medications (dobutamine and norepinephrine) - Your heart rate is 80 beats per minute or higher after ECMO was started **You may NOT be eligible if...** - You are on a permanent heart assist device (LVAD) - You have a specific type of dangerous heart rhythm requiring beta-blocker treatment - You have isolated right-side heart failure - You have signs of poor blood flow through the heart (no aortic valve opening, very low pulse pressure) - You are allergic to esmolol - You have a second- or third-degree heart block - You are pregnant - Your life expectancy is less than 24 hours - You are already in another clinical trial Talk to your doctor to see if this trial is right for you.