Acute cardiac care & resuscitation
Complications in patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation therapy: distribution and relevance. Results from an international, multicentre cohort study
Authors' conclusion
Therapy and device-related complications occur in half of all patients treated with VA-ECMO and are associated with a worse prognosis. They accumulate in some patients, especially in women.
Study context
- Population
- All-comer patients with cardiogenic shock treated with VA-ECMO, 2005–2019
- Participants
- 501 patients
- Outcome
- VA-ECMO complications (neurological, bleeding, ischaemic AEs, device-related complications) and their association with overall survival and favourable neurological outcome (cerebral performance categories 1 + 2)
Methodological detailsmulticentre, international, 16 centres in four countries
- Multicentre
- International
- 16 centres in four countries
Main finding
As reported in the abstract
≥1 device-related complication
252/486
52%
Neurological adverse events (AEs)
108/469
23%
Bleeding
192/480
40%
Ischaemic AEs
123/478
26%
Observational data: associations, not effects.
Further findings
30-day mortality
- 30-day mortality
- 40% (198/501 patients)
AEs by sex
- Aside from neurological ones, all AEs and device-related complications more likely in women; prediction of non-neurological AEs generally poor
Original publication
Complications in patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation therapy: distribution and relevance. Results from an international, multicentre cohort study. Eur Heart J Acute Cardiovasc Care. Published 24 October 2023. doi:10.
Summarised from the published abstract; every number is checked against it