ArticleCritical care (London, England)2019
Epinephrine, inodilator, or no inotrope in venoarterial extracorporeal membrane oxygenation implantation: a single-center experience.
Article in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 34 citations in OpenAlex.
- Mechanical circulatory support in cardiogenic shock: a contemporary head-to-head comparison.Heart failure reviews · 2026Review
- Cardiac Arrest Pharmacopeia: A Personalized Approach to Drug Administration During Cardiopulmonary Resuscitation.Critical care clinics · 2026Review
- Successful Weaning from VA ECMO in a Patient with a Post-Myocardial Infarction Ventricular Septal Defect and a Left Ventricle Apical Aneurysm: A Case Report.Healthcare (Basel, Switzerland) · 2025Article
- Immediate post-ECPR management strategies in the prehospital and critical care transport medicine environments.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Review
- Early Albumin Administration in Veno-Arterial Extracorporeal Membrane Oxygenation.Artificial organs · 2025Observational
- Impact of mechanical circulatory support on out-of-hospital cardiac arrest outcomes stratified by vasoactive-inotropic score: A retrospective cohort study.Resuscitation plus · 2024Article
- Clinical characteristics of extracorporeal cardiopulmonary resuscitation in China: a multicenter retrospective study.BMC anesthesiology · 2024Article
- Article
- Review
- Extracorporeal cardiopulmonary resuscitation (eCPR) and cerebral perfusion: A narrative review.Resuscitation · 2023Review
- Inodilators May Improve the In-Hospital Mortality of Patients with Cardiogenic Shock Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation.Journal of clinical medicine · 2022Article
- Extracorporeal Membrane Oxygenation in Infarct-Related Cardiogenic Shock.Journal of clinical medicine · 2022Review
- Vasoactive pharmacological management according to SCAI class in patients with acute myocardial infarction and cardiogenic shock.PloS one · 2022Article
- Hemodynamic-based Assessment and Management of Cardiogenic Shock.US cardiology · 2022Review
- Cardiogenic shock: incidence, survival and mechanical circulatory support usage 2007-2017-insights from a national registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Article
- Epinephrine administration in venoarterial extracorporeal membrane oxygenation patients is associated with mortality: a retrospective cohort study.ESC heart failure · 2021Article
- Article
- Hemodynamic monitoring in patients with venoarterial extracorporeal membrane oxygenation.Annals of translational medicine · 2020Review
- Myocardial infarction type 1 is frequent in refractory out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR).Scientific reports · 2020Article
- Epinephrine, inodilator, or no inotrope in venoarterial extracorporeal membrane oxygenation implantation: a single-center experience-an RCT would be desirable.Critical care (London, England) · 2020Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVenoarterial extracorporeal membrane oxygenation (VA-ECMO) can be a rescue therapy for patients in cardiogenic shock or in refractory cardiac arrest. After cannulation, vasoplegia and cardiac depression are frequent. In literature, there are conflicting data on inotropic therapy in these patients.
methodsAnalysis of a retrospective registry of all patients treated with VA-ECMO in a university hospital center between October 2010 and December 2018 for cardiogenic shock or extracorporeal cardiopulmonary resuscitation (eCPR) with a focus on individual early inotropic therapy.
resultsA total of 231 patients (age 58.6 ± 14.3, 29.9% female, 58% eCPR, in-house survival 43.7%) were analyzed. Of these, 41.6% received no inotrope therapy within the first 24 h (survival 47.9%), 29.0% received an inodilator (survival 52.2%), and 29.0% received epinephrine (survival 25.0%). Survival of patients with epinephrine was significantly worse compared to other patient groups when evaluating 30-day survival (p = 0.034/p = 0.005) and cumulative incidence of in-hospital death (p = 0.001). In a multivariate logistic regression analysis, treatment with epinephrine was associated with mortality in the whole cohort (OR 0.38, p = 0.011) as well as after propensity score matching (OR 0.24, p = 0.037). We found no significant differences between patients with inodilator treatment and those without.
conclusionEarly epinephrine therapy within the first 24 h after cannulation for VA-ECMO was associated with poor survival compared to patients with or without any inodilator therapy. Until randomized data are available, epinephrine should be avoided in patients on VA-ECMO.
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