Acute cardiac care & resuscitationRandomised controlled trial
Early Left Ventricular Unloading or Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD Randomized Clinical Trial
- Randomised controlled trial
- single-centre
Authors' conclusion
Among patients with cardiogenic shock undergoing VA-ECMO, early routine left ventricular unloading with transseptal left atrial cannulation did not reduce 30-day mortality compared with the conventional strategy, which permitted rescue transseptal left atrial cannulation.
Study context
- Population
- Patients with cardiogenic shock undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO), single hospital in South Korea, March 2021–September 2022all completed the trial
- Participants
- 116 patients
- Comparison
- Early routine LV unloading vs conventional approach
- Earlyn = 58
- Conventionaln = 58reference
- Primary endpoint
- All-cause mortality
- Follow-up
- 30 days
Primary result
All-cause death
Hazard ratio
1.02
95% CI 0.59–1.74
P = 0.942
Events by treatment group
Early vs Conventional
HR 1.02 (95% CI 0.59–1.74); P = 0.942
As reported in the abstract
Secondary outcomes
Time to disappearance of pulmonary congestion
P = 0.027
- Crossover to rescue transseptal left atrial cannulation (Conventional)
- 50% · 29 of 58
Other secondary outcomes
- No significant differences between the 2 groups
Original publication
Early Left Ventricular Unloading or Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD Randomized Clinical Trial. Circulation. Published 18 October 2023. doi:10.1161/circulationaha.123.066179
Summarised from the published abstract; every number is checked against it