PMID- 38527130
OWN - NLM
STAT- MEDLINE
DCOM- 20240327
LR  - 20240410
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 149
IP  - 13
DP  - 2024 Mar 26
TI  - Scrutinizing the Role of Venoarterial Extracorporeal Membrane Oxygenation: Has 
      Clinical Practice Outpaced the Evidence?
PG  - 1033-1052
LID - 10.1161/CIRCULATIONAHA.123.067087 [doi]
AB  - 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 
      benefit and safety from adequately powered randomized controlled trials. Although 
      the ARREST trial (Advanced Reperfusion Strategies for Patients with 
      Out-of-Hospital Cardiac Arrest and Refractory Ventricular Fibrillation) and a 
      secondary analysis of the PRAGUE OHCA trial (Prague Out-of-Hospital Cardiac 
      Arrest) provided some evidence in favor of VA-ECMO in the setting of 
      out-of-hospital cardiac arrest, the INCEPTION trial (Early Initiation of 
      Extracorporeal Life Support in Refractory Out-of-Hospital Cardiac Arrest) has not 
      found a relevant improvement of short-term mortality with extracorporeal 
      cardiopulmonary resuscitation. In addition, the results of the recently published 
      ECLS-SHOCK trial (Extracorporeal Life Support in Cardiogenic Shock) and ECMO-CS 
      trial (Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock) 
      discourage the routine use of VA-ECMO in patients with infarct-related 
      cardiogenic shock. Ongoing clinical trials (ANCHOR [Assessment of ECMO in Acute 
      Myocardial Infarction Cardiogenic Shock, NCT04184635], REVERSE [Impella CP With 
      VA ECMO for Cardiogenic Shock, NCT03431467], UNLOAD ECMO [Left Ventricular 
      Unloading to Improve Outcome in Cardiogenic Shock Patients on VA-ECMO, 
      NCT05577195], PIONEER [Hemodynamic Support With ECMO and IABP in Elective Complex 
      High-risk PCI, NCT04045873]) may clarify the usefulness of VA-ECMO in specific 
      patient subpopulations and the efficacy of combined mechanical circulatory 
      support strategies. Pending further data to refine patient selection and 
      management recommendations for VA-ECMO, it remains uncertain whether the present 
      usage of this device improves outcomes.
FAU - Lusebrink, Enzo
AU  - Lusebrink E
AUID- ORCID: 0000-0002-3214-5672
AD  - Department of Medicine I, LMU University Hospital, LMU Munich, Germany and DZHK 
      (German Center for Cardiovascular Research), partner site Munich Heart Alliance 
      (E.L., L.B., D.H., L.V.S., C.S., J.H., S.M., M.O.).
FAU - Binzenhofer, Leonhard
AU  - Binzenhofer L
AD  - Department of Medicine I, LMU University Hospital, LMU Munich, Germany and DZHK 
      (German Center for Cardiovascular Research), partner site Munich Heart Alliance 
      (E.L., L.B., D.H., L.V.S., C.S., J.H., S.M., M.O.).
FAU - Hering, Daniel
AU  - Hering D
AD  - Department of Medicine I, LMU University Hospital, LMU Munich, Germany and DZHK 
      (German Center for Cardiovascular Research), partner site Munich Heart Alliance 
      (E.L., L.B., D.H., L.V.S., C.S., J.H., S.M., M.O.).
FAU - Villegas Sierra, Laura
AU  - Villegas Sierra L
AUID- ORCID: 0000-0002-4838-4766
AD  - Department of Medicine I, LMU University Hospital, LMU Munich, Germany and DZHK 
      (German Center for Cardiovascular Research), partner site Munich Heart Alliance 
      (E.L., L.B., D.H., L.V.S., C.S., J.H., S.M., M.O.).
FAU - Schrage, Benedikt
AU  - Schrage B
AUID- ORCID: 0000-0001-9041-3922
AD  - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany 
      and DZHK (German Center for Cardiovascular Research), partner site 
      Hamburg/Kiel/Lubeck, Germany (B.S.).
FAU - Scherer, Clemens
AU  - Scherer C
AUID- ORCID: 0000-0003-2816-6793
AD  - Department of Medicine I, LMU University Hospital, LMU Munich, Germany and DZHK 
      (German Center for Cardiovascular Research), partner site Munich Heart Alliance 
      (E.L., L.B., D.H., L.V.S., C.S., J.H., S.M., M.O.).
FAU - Speidl, Walter S
AU  - Speidl WS
AUID- ORCID: 0000-0002-7267-3138
AD  - Division of Cardiology, Department of Internal Medicine II, Medical University of 
      Vienna, Vienna, Austria (W.S.S.).
FAU - Uribarri, Aitor
AU  - Uribarri A
AUID- ORCID: 0000-0002-6911-7480
AD  - Cardiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron 
      Institut de Recerca (VHIR), Barcelona, Spain. CIBER-CV (A.U.).
FAU - Sabate, Manel
AU  - Sabate M
AD  - Interventional Cardiology Department, Hospital Clinic, Instituto de 
      Investigaciones Biomedicas August Pi i Sunyer (IDIBAPS), University of Barcelona, 
      Spain (M.S.).
FAU - Noc, Marko
AU  - Noc M
AUID- ORCID: 0000-0003-3303-4306
AD  - Center for Intensive Internal Medicine, University Medical Center, Ljubljana, 
      Slovenia (M.N.).
FAU - Sandoval, Elena
AU  - Sandoval E
AUID- ORCID: 0000-0002-4242-5133
AD  - Department of Cardiovascular Surgery, Hospital Clinic, Barcelona, Spain (E.S.).
FAU - Erglis, Andrejs
AU  - Erglis A
AUID- ORCID: 0000-0002-3999-0182
AD  - Latvian Centre of Cardiology, Paul Stradins Clinical University Hospital, Riga, 
      Latvia (A.E.).
FAU - Pappalardo, Federico
AU  - Pappalardo F
AD  - Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, AO SS. Antonio e 
      Biagio e Cesare Arrigo, Alessandria, Italy (F.P.).
FAU - De Roeck, Frederic
AU  - De Roeck F
AUID- ORCID: 0000-0002-2795-7721
AD  - Department of Cardiology, Antwerp University Hospital, Edegem, Belgium (F.D.R.).
FAU - Tavazzi, Guido
AU  - Tavazzi G
AUID- ORCID: 0000-0002-9560-5138
AD  - Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of 
      Pavia Intensive Care, Fondazione IRCCS Policlinico San Matteo, Italy (G.T.).
FAU - Riera, Jordi
AU  - Riera J
AUID- ORCID: 0000-0002-1738-4448
AD  - Intensive Care Department, Vall d'Hebron University Hospital, and SODIR, Vall 
      d'Hebron Research Institute, Barcelona, Spain (J.R.).
FAU - Roncon-Albuquerque, Roberto Jr
AU  - Roncon-Albuquerque R Jr
AUID- ORCID: 0000-0002-2966-2943
AD  - Department of Intensive Care Medicine, Sao Joao University Hospital Center, 
      UnIC@RISE and Department of Surgery and Physiology, Faculty of Medicine of Porto, 
      Portugal (R.R.-A.).
FAU - Meder, Benjamin
AU  - Meder B
AUID- ORCID: 0000-0003-0741-2633
AD  - Department of Cardiology, Angiology, and Pneumology, University Hospital 
      Heidelberg, Germany (B.M.).
FAU - Luedike, Peter
AU  - Luedike P
AUID- ORCID: 0000-0001-7809-2142
AD  - Department of Cardiology and Vascular Medicine, West German Heart and Vascular 
      Center, University Hospital Essen (P.L., T.R.).
FAU - Rassaf, Tienush
AU  - Rassaf T
AD  - Department of Cardiology and Vascular Medicine, West German Heart and Vascular 
      Center, University Hospital Essen (P.L., T.R.).
FAU - Hausleiter, Jorg
AU  - Hausleiter J
AUID- ORCID: 0000-0003-2909-7961
AD  - Department of Medicine I, LMU University Hospital, LMU Munich, Germany and DZHK 
      (German Center for Cardiovascular Research), partner site Munich Heart Alliance 
      (E.L., L.B., D.H., L.V.S., C.S., J.H., S.M., M.O.).
FAU - Hagl, Christian
AU  - Hagl C
AD  - Department of Cardiac Surgery, LMU University Hospital, LMU Munich, Germany and 
      DZHK (German Center for Cardiovascular Research), partner site Munich Heart 
      Alliance, Germany (C.H.).
FAU - Zimmer, Sebastian
AU  - Zimmer S
AD  - Department of Internal Medicine II, Heart Center Bonn, University Hospital Bonn, 
      Venusberg-Campus 1, Germany (S.Z.).
FAU - Westermann, Dirk
AU  - Westermann D
AUID- ORCID: 0000-0002-7542-1956
AD  - Department of Cardiology and Angiology, Medical Center, University of Freiburg, 
      Germany (D.W.).
FAU - Combes, Alain
AU  - Combes A
AD  - Sorbonne Universite, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and 
      Nutrition, Paris, France, and Service de Medecine Intensive-Reanimation, Institut 
      de Cardiologie, APHP Sorbonne Universite Hopital Pitie-Salpetriere, Paris, France 
      (A.C.).
FAU - Zeymer, Uwe
AU  - Zeymer U
AUID- ORCID: 0000-0001-7077-283X
AD  - Klinikum der Stadt Ludwigshafen and Institut fur Herzinfarktforschung, 
      Ludwigshafen am Rhein, Germany (U.Z.).
FAU - Massberg, Steffen
AU  - Massberg S
AUID- ORCID: 0000-0001-7387-3986
AD  - Department of Medicine I, LMU University Hospital, LMU Munich, Germany and DZHK 
      (German Center for Cardiovascular Research), partner site Munich Heart Alliance 
      (E.L., L.B., D.H., L.V.S., C.S., J.H., S.M., M.O.).
FAU - Schafer, Andreas
AU  - Schafer A
AUID- ORCID: 0000-0003-3206-6162
AD  - Department of Cardiology and Angiology, Hannover Medical School, Germany (A.S.).
FAU - Orban, Martin
AU  - Orban M
AUID- ORCID: 0000-0001-9830-1941
AD  - Department of Medicine I, LMU University Hospital, LMU Munich, Germany and DZHK 
      (German Center for Cardiovascular Research), partner site Munich Heart Alliance 
      (E.L., L.B., D.H., L.V.S., C.S., J.H., S.M., M.O.).
FAU - Thiele, Holger
AU  - Thiele H
AUID- ORCID: 0000-0002-0169-998X
AD  - Heart Center Leipzig at University of Leipzig, Department of Internal 
      Medicine/Cardiology and Leipzig Heart Science, Germany (H.T.).
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20240325
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Humans
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - *Myocardial Infarction/etiology
MH  - *Out-of-Hospital Cardiac Arrest/therapy/etiology
MH  - *Percutaneous Coronary Intervention
MH  - Shock, Cardiogenic/diagnosis/therapy
MH  - Clinical Trials as Topic
OTO - NOTNLM
OT  - extracorporeal membrane oxygenation
OT  - heart failure
OT  - heart-lung machine
OT  - shock, cardiogenic
COIS- Disclosures None.
EDAT- 2024/03/25 18:42
MHDA- 2024/03/27 06:43
CRDT- 2024/03/25 14:12
PHST- 2024/03/27 06:43 [medline]
PHST- 2024/03/25 18:42 [pubmed]
PHST- 2024/03/25 14:12 [entrez]
AID - 10.1161/CIRCULATIONAHA.123.067087 [doi]
PST - ppublish
SO  - Circulation. 2024 Mar 26;149(13):1033-1052. doi: 
      10.1161/CIRCULATIONAHA.123.067087. Epub 2024 Mar 25.