Acute cardiac care & resuscitation
Time Course, Factors Related to, and Prognostic Impact of Venoarterial Extracorporeal Membrane Flow in Cardiogenic Shock
Authors' conclusion
In patients with refractory cardiogenic shock supported with VA-ECMO, sicker patients had higher support since early phases, presenting thereafter higher rates of ventilator-associated pneumonia but similar survival compared with patients with lower flows.
Study context
- Population
- Patients with refractory cardiogenic shock supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO)
- Participants
- 209 patients
- Exposure
- High-flow vs low-flow VA-ECMO
- High-flown = 105
- Outcome
- Evolution of VA-ECMO flows and risk factors of high-ECMO flow
- Follow-up
- First 48 h of VA-ECMO run
Methodological details7 year database
- 7 year database
Main finding
As reported in the abstract
Independent risk factors of high-flow (multivariate analysis)
Odds ratio (95% CI)
Mechanical ventilation at cannulation
3.9(2.1–7.1)
Pre-ECMO lactate
1.1(1.0–1.2)
Observational data: associations, not effects.
Further findings
Days on mechanical ventilation
P = 0.009
Lengths of stay and survival
- No differences in lengths of stay or survival according to ECMO flow
Safety
Ventilator-associated pneumonia
P = 0.007
Original publication
Time Course, Factors Related to, and Prognostic Impact of Venoarterial Extracorporeal Membrane Flow in Cardiogenic Shock. ESC Heart Fail. Published 11 November 2022. doi:10.
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