Acute cardiac care & resuscitation
Prognostic echocardiographic findings in patients supported with venoarterial extracorporeal membrane oxygenation for cardiogenic shock
Authors' conclusion
The initial echocardiogram was most likely to demonstrate a critical finding of which the most common was minimal to no LV ejection. Critical echocardiographic findings carried prognostic significance for in-hospital mortality.
Study context
- Population
- Patients with cardiogenic shock supported with V-A ECMO, Toronto General Hospital, 2011–2018
- Participants
- 130 patients
- Exposure
- Critical echocardiographic finding vs none
- Outcome
- Incidence of critical echocardiographic findings (minimal to no LV ejection, intracardiac clot, significant pericardial effusion, malpositioned ECMO cannulae) and their prognostic significance
Methodological detailssingle-centre, Retrospective review of all available echocardiograms, hemodynamic variables and outcomes
- Single-centre
- Retrospective review of all available echocardiograms, hemodynamic variables and outcomes
Main finding
As reported in the abstract
Critical findings in first echocardiogram
- Any critical finding, first echocardiogram
- 42/121; 35%
- Minimal to no left ventricular (LV) ejection
- 28 (23%)
- Intracardiac thromboses
- 8 (6.6%)
- Tamponade
- 5 (4%)
- Malpositioned cannulae
- 1 (0.8%)
- In-hospital mortality, critical finding in first study
- OR 2.32 (95% CI 1.01-5.06, P = 0.011)
Observational data: associations, not effects.
Further findings
In-hospital mortality (overall)
- In-hospital mortality
- 58.5%
Original publication
Prognostic echocardiographic findings in patients supported with venoarterial extracorporeal membrane oxygenation for cardiogenic shock. Eur Heart J Acute Cardiovasc Care. Published 13 April 2023. doi:10.
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