ArticleJournal of the American College of Cardiology2022
Mechanical Left Ventricular Unloading in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation.
Article in Journal of the American College of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 74 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Embedded Multifactorial Adaptive Platform in ExtraCorporeal Membrane Oxygenation (REMAP ECMO) - Left Ventricular Unloading Study
A Multicentric Left Ventricular Venting Strategy Comparison in Patients Receiving Venoarterial Extracorporeal Life Support
Who cites it
74 citing papers in PubMed, 4 syntheses or guidelines pooled it, 197 citations in OpenAlex.
- Meta-analysis of the predictive value of critical care echocardiography for weaning outcomes in patients with VA-ECMO-assisted cardiogenic shock.Frontiers in medicine · 2026Pooled it
- Impact of left ventricular unloading timing on clinical outcomes in venoarterial extracorporeal membrane oxygenation: an updated systematic review and meta-analysis.BMC cardiovascular disorders · 2025Pooled it
- Early left ventricular unloading during extracorporeal membrane oxygenation in cardiogenic shock: A systematic review and meta-analysis.Artificial organs · 2025Pooled it
- Efficacy of venoarterial extracorporeal membrane oxygenation with and without intra-aortic balloon pump in adult cardiogenic shock.Frontiers in cardiovascular medicine · 2024Pooled it
- Early Lower Pulmonary Arterial Diastolic Pressure Monitored With Pulmonary Arterial Catheters Is Associated With Improved Survival During VA ECMO for Patients With Acute Cardiogenic Shock: A Propensity-Matched Study.JACC. Heart failure · 2026Article
- Left ventricular unloading during VA-ECMO for refractory cardiogenic shock: a target trial emulation multicenter analysis.Critical care (London, England) · 2026Article
- Clinical outcomes of VA-ECMO in children with fulminant myocarditis: a single-centre case series.BMC pediatrics · 2026Article
- Hemi-ECMO: A Novel Method of Left Ventricular Afterload Reduction for Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO).Bioengineering (Basel, Switzerland) · 2026Article
- Incidence and In-Hospital Mortality of Ventricular Septal Rupture Following Acute Myocardial Infarction.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Venoarterial extracorporeal membrane oxygenation in adults with cardiogenic shock.Frontiers in cardiovascular medicine · 2026Review
- Myocarditis in the Modern Era: Navigating Diagnosis, Innovative Treatments, the COVID-19 Challenge and the Role of Artificial Intelligence.Cardiology research and practice · 2026Review
- Outcomes of heart failure hospitalizations at urban teaching vs. Non-Teaching Hospitals: A Nationwide Propensity Score Matched Analysis in the United States.European heart journal open · 2026Article
- Successful VA-ECMO rescue of life-threatening cardiotoxicity following paclitaxel and cisplatin neoadjuvant chemotherapy for laryngeal cancer: a case report.BMC cardiovascular disorders · 2025Article
- Optimizing IABP-patient interaction in VA-ECMO via transcranial doppler.The ultrasound journal · 2025Article
- A Contemporary Guide of Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock.Journal of cardiovascular development and disease · 2025Review
- Rare Intraoperative Left Coronary Artery Dissection in Acute Type A Aortic Dissection: VA-ECMO-Assisted Coronary Artery Bypass Grafting.Clinical case reports · 2025Article
- 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
- ECMO management in cardiogenic shock-specialized versus non-cardiogenic shock-specialized centers: a registry-based analysis.BMC anesthesiology · 2025Article
- Beyond Standard Parameters: Precision Hemodynamic Monitoring in Patients on Veno-Arterial ECMO.Journal of personalized medicine · 2025Review
- Microaxial-Flow Pump on Top of Atrial Septostomy for LV Decompression Strategy in ECMO-Supported MI-CS.JACC. Case reports · 2025Article
14 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundVenoarterial extracorporeal membrane oxygenation (VA-ECMO) increases left ventricular (LV) afterload, potentially provoking LV distention and impairing recovery. LV mechanical unloading (MU) with intra-aortic balloon pump (IABP) or percutaneous ventricular assist device (pVAD) can prevent LV distension, potentially at the risk of more complications, and net clinical benefit remains uncertain.
objectivesThis study aims to determine the association between MU and outcomes for patients undergoing VA-ECMO.
methodsThe authors queried the Extracorporeal Life Support Organization registry for adults receiving peripheral VA-ECMO from 2010 to 2019 and stratified them by MU with IABP or pVAD. The primary outcome was in-hospital mortality; secondary outcomes included on-support mortality and complications during VA-ECMO.
resultsAmong 12,734 VA-ECMO patients, 3,399 (26.7%) received MU: 2,782 (82.9%) IABP and 580 (17.1%) pVAD. MU patients were older (age 56.3 vs 52.7 years) and, before extracorporeal membrane oxygenation, more often required >2 vasopressors (41.7% vs 27.2%) and had respiratory (21.1% vs 15.9%), renal (24.6% vs 15.8%), and liver failure (4.4% vs 3.1%) (all P < 0.001). MU patients had lower in-hospital mortality (56.6% vs 59.3%, P = 0.006), which persisted in multivariable modeling (adjusted OR [aOR]: 0.84; 95% CI: 0.77-0.92; P < 0.001). MU was associated with more cannula site bleeding (aOR: 1.25; 95% CI: 1.11-1.40; P < 0.001) and hemolysis (aOR: 1.27; 95% CI: 1.03-1.57; P = 0.02). Compared to pVAD, MU patients with IABP had similar mortality (aOR: 0.80; 95% CI: 0.64-1.01; P = 0.06) and less medical bleeding (aOR: 0.45; 95% CI: 0.31-0.64; P < 0.001), cannula site bleeding (aOR: 0.72; 95% CI: 0.54-0.96; P = 0.03), and renal injury (aOR: 0.78; 95% CI: 0.62-0.98; P = 0.03).
conclusionsAmong adults receiving VA-ECMO, MU was associated with lower in-hospital mortality despite increased complications including hemolysis and cannulation site bleeding. Compared to pVAD, MU with IABP was associated with similar mortality and lower complication rates.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.