Review
Critical Care Medicine
Waiel Abusnina, Mahmoud Ismayl, Ahmad Al-abdouh, Vaishnavi Ganesan, Mostafa Reda Mostafa, Osama Hallak, Emily Peterson, Mahmoud Abdou, Andrew M. Goldsweig, Ahmed Aboeata, Khagendra Dahal
Summary: This study compared the clinical outcomes of Impella versus extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock (CS). The results showed that the use of Impella was associated with lower rates of in-hospital mortality, bleeding, and stroke compared to ECMO.
Article
Medicine, General & Internal
Dengbang Hou, Hong Wang, Feng Yang, Xiaotong Hou
Summary: This study aimed to describe the prevalence of neurologic complications and hospital outcome in adult post-cardiotomy cardiogenic shock patients receiving V-A ECMO support. Neurologic complications were frequent in these patients and associated with higher in-hospital mortality. Identified risk factors of neurologic complications might help improve ECMO management and reduce their occurrence.
FRONTIERS IN MEDICINE
(2021)
Article
Medicine, General & Internal
Piotr Duchnowski
Summary: This study found that elevated preoperative NT-proBNP levels are associated with an increased risk of postoperative cardiogenic shock requiring ECMO in patients undergoing heart valve surgery.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Nadezda Scupakova, Karolis Urbonas, Agne Jankuviene, Lina Puodziukaite, Povilas Andrijauskas, Vilius Janusauskas, Aleksejus Zorinas, Kestutis Laurusonis, Pranas Serpytis, Robertas Samalavicius
Summary: The study evaluated the outcomes of octogenarian and septuagenarian patients receiving ECMO therapy, and found that there were no significant differences in demographic and perioperative variables between the two groups. The results showed that ECMO could successfully support the treatment of cardiac failure in octogenarian patients, and an early decision to initiate ECMO therapy was associated with favorable outcomes.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Adamantios Tsangaris, Tamas Alexy, Rajat Kalra, Marinos Kosmopoulos, Andrea Elliott, Jason A. Bartos, Demetris Yannopoulos
Summary: Cardiogenic shock leads to a significant number of hospital admissions in the United States each year, with a high in-hospital mortality rate. VA-ECMO is an advanced temporary life support system that provides immediate and complete hemodynamic support and gas exchange for patients with various etiologies of cardiogenic shock. Understanding the indications, contraindications, and complications associated with VA-ECMO use is crucial in improving outcomes for these patients.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Medicine, General & Internal
Klaudia J. Koziol, Ameesh Isath, Shiavax Rao, Vasiliki Gregory, Suguru Ohira, Sean Van Diepen, Roberto Lorusso, Chayakrit Krittanawong
Summary: Cardiogenic shock is a life-threatening condition characterized by low cardiac output and end-organ dysfunction. Despite advances in treatment, it still has a high mortality rate. Extracorporeal membrane oxygenation (ECMO) has been increasingly used to support patients with cardiogenic shock, but more research is needed to determine its efficacy and safety. This review provides an overview of ECMO in cardiogenic shock, including indications, contraindications, complications, and outcomes, with a focus on recent randomized controlled trials.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Anne-Kristin Schaefer, Julia Riebandt, Martin H. Bernardi, Klaus Distelmaier, Georg Goliasch, Daniel Zimpfer, Gunther Laufer, Dominik Wiedemann
Summary: Post-cardiotomy extracorporeal life support (PC-ECLS) is a potentially life-saving resource for patients with cardiopulmonary failure after cardiac surgery. However, even in successfully weaned patients, adverse outcomes have been reported. This study aimed to assess the outcomes of patients weaned from PC-ECLS. The results showed that in-hospital mortality was high, and factors such as longer ECLS duration, older age, female gender, and low preoperative glomerular filtration rate were associated with higher mortality. However, the survival rate of patients discharged after PC-ECLS was encouraging.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Fausto Biancari, Andrea Perrotti, Vito G. Ruggieri, Giovanni Mariscalco, Magnus Dalen, Angelo M. Dell'Aquila, Kristjan Jonsson, Sigurdur Ragnarsson, Dario Di Perna, Karl Bounader, Giuseppe Gatti, Tatu Juvonen, Khalid Alkhamees, Hakeem Yusuff, Antonio Loforte, Andrea Lechiancole, Sidney Chocron, Marek Pol, Cristiano Spadaccio, Matteo Pettinari, Dieter De Keyzer, Antonio Fiore, Henryk Welp
Summary: VA-ECMO support for post-cardiotomy cardiogenic shock after adult cardiac surgery is associated with satisfactory 5-year survival, with age being a key factor affecting survival, especially in patients over 70 years old. A small percentage of patients underwent ventricular assist device implantation or heart transplant, with higher 5-year survival rates observed in this group. Future studies should assess the functional outcomes of these patients with mid-term survival.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2021)
Article
Cardiac & Cardiovascular Systems
Santiago Montero, Mercedes Rivas-Lasarte, Florent Huang, Juliette Chommeloux, Pierre Demondion, Nicolas Brechot, Guillaume Hekimian, Guillaume Franchineau, Romain Persichini, Charles-Edouard Luyt, Cosme Garcia-Garcia, Antoni Bayes-Genis, Guillaume Lebreton, Juan Cinca, Pascal Leprince, Alain Combes, Jesus Alvarez-Garcia, Matthieu Schmidt
Summary: This study aimed to describe the evolution of VA-ECMO flows in patients with cardiogenic shock and identify the risk factors associated with high ECMO flow. The results showed that sicker patients had higher support with ECMO, leading to higher rates of complications, but no significant differences were found in hospitalization length or survival between high-flow and low-flow groups.
Article
Cardiac & Cardiovascular Systems
Anne-Kristin Schaefer, Michaela Latus, Julia Riebandt, Georg Goliasch, Martin H. Bernardi, Guenther Laufer, Daniel Zimpfer, Dominik Wiedemann
Summary: This study retrospectively analyzed patients undergoing post-cardiotomy extracorporeal life support (ECLS) and found that bleeding and thrombotic events were common and significantly affected survival. Preoperative dual antiplatelet therapy and ECLS duration were identified as independent risk factors for bleeding, while prior stroke/transient ischaemic attack and ECLS duration were identified as risk factors for thrombotic events.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)
Article
Medicine, General & Internal
Holger Thiele, Uwe Zeymer, Ibrahim Akin, Michael Behnes, Tienush Rassaf, Amir Abbas Mahabadi, Ralf Lehmann, Ingo Eitel, Tobias Graf, Tim Seidler, Andreas Schuster, Carsten Skurk, Daniel Duerschmied, Peter Clemmensen, Marcus Hennersdorf, Stephan Fichtlscherer, Ingo Voigt, Melchior Seyfarth, Stefan John, Sebastian Ewen, Axel Linke, Eike Tigges, Peter Nordbeck, Leonhard Bruch, Christian Jung, Jutta Franz, Philipp Lauten, Tomaz Goslar, Hans-Josef Feistritzer, Janine Poess, Eva Kirchhof, Taoufik Ouarrak, Steffen Schneider, Steffen Desch, Anne Freund, ECLS-SHOCK Investigators
Summary: In patients with acute myocardial infarction complicated by cardiogenic shock, early extracorporeal life support (ECLS) combined with standard medical treatment did not reduce mortality.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Liangshan Wang, Juanjuan Shao, Chengcheng Shao, Hong Wang, Ming Jia, Xiaotong Hou
Summary: The study found that in post-cardiotomy cardiogenic shock patients undergoing VA-ECMO, a large relative decrease in platelet count on the first day after ECMO initiation is independently associated with increased in-hospital mortality. The predictive value of this indicator was better than the absolute platelet count on day 1.
FRONTIERS IN MEDICINE
(2021)
Article
Medicine, General & Internal
Anne Freund, Steffen Desch, Janine Poess, Dmitry Sulimov, Marcus Sandri, Nicolas Majunke, Holger Thiele
Summary: Mortality in infarct-related cardiogenic shock remains high, and active mechanical circulatory support devices such as VA-ECMO are rapidly evolving. However, supporting evidence of VA-ECMO therapy in this condition is lacking. Research on patient selection and potential complications is ongoing.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Santiago Montero, Florent Huang, Mercedes Rivas-Lasarte, Juliette Chommeloux, Pierre Demondion, Nicolas Brechot, Guillaume Hekimian, Guillaume Franchineau, Romain Persichini, Charles-Edouard Luyt, Cosme Garcia-Garcia, Antoni Bayes-Genis, Guillaume Lebreton, Juan Cinca, Pascal Leprince, Alain Combes, Jesus Alvarez-Garcia, Matthieu Schmidt
Summary: Maintaining patients in refractory cardiogenic shock awake during cannulation and VA-ECMO run is associated with lower rates of ventilator-associated pneumonia and ECMO-related complications, reduced need for renal replacement therapy and antibiotic/sedative consumption, as well as significantly decreased 60-day and 1-year mortality rates. MV at ECMO cannulation is independently associated with 60-day mortality.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2021)
Article
Critical Care Medicine
Sasa Rajsic, Benedikt Treml, Dragana Jadzic, Robert Breitkopf, Christoph Oberleitner, Marina Popovic Krneta, Zoran Bukumiric
Summary: This study analyzed the in-hospital mortality and complication rates of va-ECMO in patients with cardiogenic shock. The findings showed that va-ECMO is an invasive life support with a high risk of complications, and the in-hospital mortality rate was 62%. Patient age, infection, and ECMO support duration were associated with a higher mortality rate. Therefore, protocols and techniques should be developed to reduce adverse events, and randomized trials are needed to demonstrate the effectiveness of va-ECMO in treating cardiogenic shock.
ANNALS OF INTENSIVE CARE
(2022)
