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Hemodynamics Management

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Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock (ECMO-CS) trial



  • The ECMO-CS trial was conducted to compare the effects of immediate implementation of VA-ECMO vs. an initially conservative therapy in patients with rapidly deteriorating or severe cardiogenic shock.

  • The primary endpoint was the composite of death from any cause, resuscitated circulatory arrest, and implementation of another mechanical circulatory support device at 30 days.

  • A total of 122 patients were randomized, and 117 subjects were included in the analysis after excluding 5 patients due to the absence of informed consent.

  • The composite primary endpoint occurred in 37 (63.8%) and 42 (71.2%) of patients in the immediate VA-ECMO and the no early VA-ECMO groups, respectively (hazard ratio, 0.72; 95% confidence intervals [CI], 0.46 to 1.12; P=0).

  • VA-ECMO was used in 23 (39%) of no early VA-OCO patients downstream due to worsening hemodynamic status..

  • Immediate implementation of VA-ECOMO did not improve clinical outcomes compared with an early conservative strategy that permitted downstream use if needed .


M B
ekseibi
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