Does Immediate ECMO for Cardiogenic Shock Improve Survival?

A randomized study found no benefit at 30 days for immediate versus delayed or no ECMO therapy.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) can rapidly stabilize the hemodynamics of patients with cardiogenic shock, but its effect on clinical outcomes is less clear. In this multicenter trial from the Czech Republic, patients with rapidly deteriorating or severe cardiogenic shock (SCAI stage D or E based on echocardiographic, hemodynamic and metabolic criteria) were randomly assigned to immediate VA-ECMO or early conservative care. In the latter arm, ECMO could be later instituted for worsening hemodynamic status.

The most common indications for trial inclusion were ST-segment–elevation myocardial infarction (50%) and decompensated heart failure (23%). Among 117 patients (median age, 66 years) enrolled over 8 years, the in…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)