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Mechanical circulatory support in cardiogenic shock: translating trial evidence into real-world practice

Abstract While iterative developments have improved outcomes of patients with myocardial infarction, mortality in patients with acute myocardial infarction cardiogenic shock (AMI-CS) remains stubbornly high. Several promising treatments have ultimately..

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Mechanical Circulatory Support for Acute Myocardial Infarction Cardiogenic Shock: Review and Recent Updates

Abstract Cardiogenic shock (CS) in acute myocardial infarction (AMI) is a life-threatening syndrome characterized by systemic hypoperfusion that can quickly progress to multiorgan failure and death. Various devices and configurations..

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The Role of Venoarterial Ecmo in the Management of Sepsis-Induced Cardiomyopathy and Refractory Shock: An Analytic Review

Abstract Sepsis-induced cardiomyopathy is a severe complication seen in patients with refractory septic shock, characterized by cardiac dysfunction due to an overwhelming inflammatory response secondary to infection. Despite its reversible..

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A Novel Predictive Score Model for Successful Weaning From Mechanical Circulatory Support in Patients With Cardiogenic Shock

Abstract Background Clinical evidence regarding predictors of successful weaning from mechanical circulatory support (MCS) is lacking. This study aimed to create a simple risk score to predict successful weaning from..

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ECPella 5+ in Patients With Cardiogenic Shock: Potential for Improved Outcomes

Abstract The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for temporary mechanical circulatory support (MCS) is a common treatment in patients with cardiogenic shock (CS) but is associated with high..

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Extracorporeal Membrane Oxygenation: Consideration of Human Factors in Intensive Care Patients

Abstract Background Approximately 6000 intensive care units (ICUs) in the United States maintain extracorporeal membrane oxygenation (ECMO) programs.1 Patients who require ECMO are among the most critically ill in the ICU...

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Venoarterial Extracorporeal Membrane Oxygenation: A Better Pressor

Abstract PROFOUND HYPOTENSION AND end-organ hypoperfusion are most often the consequence of inadequate systemic blood flow from primary cardiac failure (cardiogenic shock) or hemorrhage (hemorrhagic shock). However, profound hypotension may..

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Extracorporeal Membrane Oxygenation Cannulation Site Affects Coronary and Cerebral Perfusion When Combined With Intra-Aortic Balloon Pump

Abstract The use of intra-aortic balloon pump (IABP) alongside venoarterial extracorporeal membrane oxygenation (VA-ECMO) in critically ill patients presenting refractory cardiogenic shock raises questions regarding its impact on organs perfusion...

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A Comprehensive Review of Left Atrial Venoarterial Extracorporeal Membrane Oxygenation

Abstract Cardiogenic shock (CS) in patients with structural heart disease (SHD) and severe valvular abnormalities poses unique challenges to traditional mechanical circulatory support (MCS) strategies, such as intra-aortic balloon pumps..

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Comparison of Hemodynamic Circulation in Pulsatile and Nonpulsatile Extracorporeal Membrane Oxygenation Systems Using an In-Vitro Heart Model

Abstract This study conducts an in-vitro experiment using a mock circulation system that mimics human circulation to assess the veno-arterial extracorporeal membrane oxygenation (ECMO) system. This study aims to compare the hemodynamic..

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Veno-Arterial Extracorporeal Membrane Oxygenation: A Better Pressor

Introduction Profound hypotension and end-organ hypoperfusion is most often a consequence of inadequate systemic blood flow from primary cardiac failure (cardiogenic shock) or hemorrhage (hemorrhagic shock). However, profound hypotension may..

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The dosage makes the poison – ECMO support considerations in poisoning

Abstract Acute poisoning may lead to life-threatening conditions that require advanced life support, such as extracorporeal membrane oxygenation (ECMO). Data about the use of ECMO in intoxications and overdose are..

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Cholesterol levels as a predictive marker for ICU survival in patients with cardiogenic shock supported by VenoArterial ExtraCorporeal membrane oxygenation

Abstract Background Veno-Arterial Extracorporeal Life Support (VA ECMO) is a critical intervention for patients with cardiogenic shock, serving as bridge to recovery, transplantation, or long-term therapies. The complexity of VA..

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Does Levosimendan hasten veno-arterial ECMO weaning? A propensity score matching analysis

Abstract Background Preliminary evidence from small, single-center studies suggests levosimendan may improve the likelihood of successful venoarterial extracorporeal membrane oxygenation (VA-ECMO) weaning in patients with cardiogenic shock. However, the literature..

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Venoarterial Extracorporeal Membrane Oxygenation Therapy in Patients with Sickle Cell Disease: Case Series and Review for Intensive Care Physicians

Abstract Sickle cell disease (SCD) is associated with substantial morbidity and early mortality in afflicted adults. Cardiopulmonary complications that occur at increased frequency in SCD such as pulmonary embolism, pulmonary..

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Redefining ECMO cannulation: A case for TEE-guided VP ECMO and flotation catheter

Abstract Venopulmonary ECMO (VP ECMO) is an advanced support strategy for patients with severe respiratory failure and right ventricular (RV) dysfunction, providing pulmonary protection by oxygenating blood and unloading the..

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Early Intra-Aortic Balloon Support for Heart Failure-Related Cardiogenic Shock: A Randomized Clinical Trial

Abstract Background The impact of intra-aortic balloon pump (IABP) on survival and successful bridging to heart replacement therapies (HRT) in patients with heart failure–cardiogenic shock (HF-CS) remains unclear. Objectives The..

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Fluid management in adult patients undergoing venoarterial extracorporeal membrane oxygenation: A scoping review

Abstract Background The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a cardiocirculatory support has tremendously increased in critically ill patients. Although fluid therapy is an essential component of the..

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Rising Above the Limits of Critical Care ECMO: A Narrative Review

Abstract Extracorporeal membrane oxygenation (ECMO), an advanced life support method, was developed to treat severe cardiac and pulmonary failure in critically ill patients. ECMO was previously used to treat ARDS,..

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Antepartum Extracorporeal Life Support: A Viable Way to Improve Fetal Outcomes

Abstract Extracorporeal life support (ECLS) has become increasingly common in the United States to manage refractory cardiopulmonary failure and has been used in complex populations including pregnant women. Application of..

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Scrutinizing the Role of Venoarterial Extracorporeal Membrane Oxygenation: Has Clinical Practice Outpaced the Evidence?

Abstract The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for temporary mechanical circulatory support in various clinical scenarios has been increasing consistently, despite the lack of sufficient evidence regarding its..

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Early Intra-Aortic Balloon Support for Heart Failure-Related Cardiogenic Shock: A Randomized Clinical Trial

Abstract Background The impact of intra-aortic balloon pump (IABP) on survival and successful bridging to heart replacement therapies (HRT) in patients with heart failure–cardiogenic shock (HF-CS) remains unclear. Objectives The..

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Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation

Abstract Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used to treat cardiogenic shock. However, VA-ECMO might hamper myocardial recovery. The Impella unloads the left ventricle. This study aimed to..

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In Silico Analysis of Pulsatile Flow Veno-Arterial Extracorporeal Membrane Oxygenation on Human Aorta Model

Abstract Electrocardiogram (ECG)—synchronized pulsatile veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a recent development in extracorporeal therapy for patients with severe cardiogenic shock. Although preclinical studies have shown benefits of..

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Expert consensus on the use of human serum albumin in critically ill patients

Abstract Human serum albumin (HSA) is a non-glycosylated, negatively charged, single-chain polypeptide composed of 585 amino acid residues with a relative molecular mass of 66.438 kD. It is synthesized by..

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Comparison of Extracorporeal Membrane Oxygenation Initiation in Cardiogenic Shock During Work-Hours Versus After-Hours

Abstract Background Extracorporeal membrane oxygenation (ECMO) as rescue therapy for cardiogenic shock (CS) is highly dependent on timeliness and medical resources. Objectives Aimed to assess ECMO management and outcomes in..

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Can utilization of the venous-to-arterial carbon dioxide difference improve patient outcomes in cardiogenic shock? A narrative review

Abstract Cardiogenic shock (CS) is a critical condition with high mortality, characterized by reduced cardiac output (CO) and tissue hypoperfusion, despite advancements in treatment. Traditional hemodynamic markers like CO measurements,..

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Obesity and Venoarterial Extracorporeal Membrane Oxygenation Outcomes: The Plot Thickens

Abstract We read with great interest a recent article on the association between body mass index (BMI) and outcomes in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). In a review..

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Parallel Venovenous Extracorporeal Membrane Oxygenation Circuits During Bridge-to-Lung Transplantation

Abstract Venovenous (VV) extracorporeal membrane oxygenation (ECMO) supports end-organ oxygen delivery in patients with refractory respiratory failure. Physical therapy (PT) while on ECMO provides conceptual benefits of strength and conditioning...

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Treatment time limit for successful weaning from veno‐arterial extracorporeal membrane oxygenation in cardiogenic shock

Abstract Aims Knowing the upper time limit for successful weaning from temporary mechanical circulatory support in cardiogenic shock will help with decision‐making regarding advanced heart failure (HF) therapy or considering..

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