Acute cardiac care & resuscitationCohort study
Incidence and Predictors of Weaning Failure From Veno-Arterial Extracorporeal Membrane Oxygenation Therapy in Patients With Cardiogenic Shock
- Retrospective cohort study
- multicentre
Authors' conclusion
Weaning from VA-ECMO fails in 40% of patients treated with VA-ECMO for CS. When successful, survival after VA-ECMO weaning mostly depends on age and the incidence of device- and shock-related complications.
Study context
- Population
- Patients with cardiogenic shock treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO), 23 tertiary care centres in 7 countries
- Participants
- 685 patients · 23 centres · 7 countries
- Outcome
- Weaning failure (death on or within 48 h after VA-ECMO support) and in-hospital death after successful weaning
Main finding
As reported in the abstract
Weaning from VA-ECMO
- Successfully weaned
- 410 (59.9%)
- Weaning failed
- 275 (40.1%)
- In-hospital death after successful weaning
- 150 (36.6%)
- Predictor of weaning failure: age (per 10 years), OR
- 1.49 (1.25-1.76); p < 0.001 (95% CI)
- Predictor of weaning failure: cardiac arrest before VA-ECMO, OR
- 1.64 (1.01-2.64); p = 0.04 (95% CI)
- Lactate clearance within 24 h associated with successful weaning, OR
- 0.21 (0.1-0.44); p < 0.001 (95% CI)
- Predictor of in-hospital death after weaning: age (per 10 years), OR
- 1.56 (1.24-1.97); p < 0.001 (95% CI)
- Predictor of in-hospital death after weaning: renal replacement therapy, OR
- 2.56 (1.4-4.68); p = 0.002 (95% CI)
- Predictor of in-hospital death after weaning: bleeding events, OR
- 2.93 (1.4-6.14); p = 0.004 (95% CI)
Observational data: associations, not effects.
Original publication
Incidence and Predictors of Weaning Failure From Veno-Arterial Extracorporeal Membrane Oxygenation Therapy in Patients With Cardiogenic Shock. Eur J Heart Fail. Published 17 January 2025. doi:10.1002/ejhf.3583
Summarised from the published abstract; every number is checked against it