{"id":1360,"date":"2026-03-14T17:10:52","date_gmt":"2026-03-14T17:10:52","guid":{"rendered":"https:\/\/perfusfind.com\/ic\/?p=1360"},"modified":"2026-03-14T17:10:52","modified_gmt":"2026-03-14T17:10:52","slug":"a-simple-va-ecmo-bundle-in-adult-patients-with-cardiogenic-shock-an-analysis-of-elso-registry","status":"publish","type":"post","link":"https:\/\/perfusfind.com\/ic\/index.php\/2026\/03\/14\/a-simple-va-ecmo-bundle-in-adult-patients-with-cardiogenic-shock-an-analysis-of-elso-registry\/","title":{"rendered":"A simple VA-ECMO bundle in adult patients with cardiogenic shock: an analysis of ELSO registry"},"content":{"rendered":"<h3 id=\"ember62\" class=\"ember-view reader-text-block__heading-3\">Abstract<\/h3>\n<p id=\"ember63\" class=\"ember-view reader-text-block__paragraph\">This registry-based cohort study of 7,950 adult patients with cardiogenic shock supported with VA-ECMO reveals that achieving a <strong>simple physiological bundle within the first 24 hours<\/strong>\u2014Mean Arterial Pressure &gt;65 mmHg, PaO\u2082 between 60\u2013150 mmHg, limiting PaCO\u2082 reduction to &gt; \u221250%, and Peak Inspiratory Pressure &lt;30 cm H\u2082O\u2014was associated with significantly higher survival to hospital discharge (55.9% vs 39.4%; adjusted OR 1.85), along with reduced rates of brain death, ischemic stroke, hemorrhage, and cardiovascular complications.<\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember64\" class=\"ember-view reader-text-block__heading-3\">Key Insights<\/h3>\n<ol>\n<li><strong>Study design:<\/strong> A retrospective analysis of the Extracorporeal Life Support Organization (ELSO) registry (2013\u20132022).<\/li>\n<li><strong>Bundle components:<\/strong> MAP &gt;65 mmHg, normoxia, controlled PaCO\u2082 change, and lung-protective ventilation.<\/li>\n<li><strong>Survival benefit:<\/strong> Bundle adherence linked to ~16.5% absolute increase in survival; adjusted odds ratio ~1.85.<\/li>\n<li><strong>Reduced complications:<\/strong> Significant reductions in brain death, stroke, hemorrhagic and cardiovascular events.<\/li>\n<li><strong>Implementation gap:<\/strong> Only 34.7% of patients met all 4 criteria; highlights real-world challenges in achieving early bundle targets.<\/li>\n<\/ol>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember66\" class=\"ember-view reader-text-block__heading-3\">Why This Matters<\/h3>\n<p id=\"ember67\" class=\"ember-view reader-text-block__paragraph\">This study identifies a <strong>practical, evidence-based intervention<\/strong> that could markedly improve survival and reduce complications in VA-ECMO-supported cardiogenic shock, using readily available physiological targets.<\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember68\" class=\"ember-view reader-text-block__heading-3\">Take-Home for Clinicians<\/h3>\n<ul>\n<li>Implement this 4-point bundle within the first 24 hours of VA-ECMO to improve outcomes.<\/li>\n<li>Monitor MAP, PaO\u2082, PaCO\u2082 trends, and PIP rigorously\u2014early non-compliance is common and measurable.<\/li>\n<li>Data underscores need for operational checklists to boost bundle adherence.<\/li>\n<\/ul>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember70\" class=\"ember-view reader-text-block__heading-3\">Conclusion<\/h3>\n<p id=\"ember71\" class=\"ember-view reader-text-block__paragraph\">Meeting this simple physiologic bundle quickly after VA-ECMO initiation significantly increases survival and reduces complications. Prospective validation and operational strategies to improve adherence are urgently needed.<\/p>\n<p><strong><a class=\"article-editor-link article-editor-link\" style=\"font-size: 16px; background-color: #ffffff;\" href=\"https:\/\/www.thelancet.com\/journals\/eclinm\/article\/PIIS2589-5370%2825%2900355-4\/fulltext\" rel=\"noopener noreferrer\">ACCESS FULL ARTICLE HERE<\/a><\/strong><\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-medium wp-image-1362\" src=\"https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1755565492798-300x300.png\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1755565492798-300x300.png 300w, https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1755565492798-150x150.png 150w, https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1755565492798.png 450w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p id=\"ember81\" class=\"ember-view reader-text-block__paragraph\"><strong>Open Access<\/strong> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article&#8217;s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article&#8217;s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit <a class=\"aAIDarVlJjjXEMUykBwFgJhXtzETCscLwRim \" tabindex=\"0\" href=\"http:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_self\" data-test-app-aware-link=\"\"><strong>http:\/\/creativecommons.org\/licenses\/by\/4.0\/<\/strong><\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Abstract This registry-based cohort study of 7,950 adult patients with cardiogenic shock supported with VA-ECMO reveals that achieving a simple physiological bundle within the first 24 hours\u2014Mean Arterial Pressure &gt;65 mmHg, PaO\u2082 between 60\u2013150 mmHg, limiting PaCO\u2082 reduction to &gt; \u221250%, and Peak Inspiratory Pressure &lt;30 cm H\u2082O\u2014was associated with significantly higher survival to hospital [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1361,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center 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href=\"https:\/\/perfusfind.com\/ic\/index.php\/category\/circulatory\/\" rel=\"category tag\">Circulatory<\/a>","rttpg_excerpt":"Abstract This registry-based cohort study of 7,950 adult patients with cardiogenic shock supported with VA-ECMO reveals that achieving a simple physiological bundle within the first 24 hours\u2014Mean Arterial Pressure &gt;65 mmHg, PaO\u2082 between 60\u2013150 mmHg, limiting PaCO\u2082 reduction to &gt; \u221250%, and Peak Inspiratory Pressure &lt;30 cm H\u2082O\u2014was associated with significantly higher survival to 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