ArticleLife (Basel, Switzerland)2023
Left Ventricular Unloading in Patients on Venoarterial Extracorporeal Membrane Oxygenation Therapy in Cardiogenic Shock: Prophylactic Versus Bail-Out Strategy.
Article in Life (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- 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
- Concomitant Impella 5.5 with venoarterial extracorporeal membrane oxygenation via modified single arterial access technique using buried Y-graft.Cardiology journal · 2026Article
- Heart support crossroads: aortic Impella 5.5 implantation compared to conventional axillary approach in combined use of extracorporeal membrane oxygenation and Impella (ECMELLA) setting.Journal of thoracic disease · 2025Article
- Anticoagulation and associated complications in veno-arterial extracorporeal membrane oxygenation in adult patients: A systematic review and meta-analysis.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Review
- Temporary extracorporeal life support: single-centre experience with a new concept.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- From escalation to weaning strategies: how to integrate the ECMELLA concept.European heart journal supplements : journal of the European Society of Cardiology · 2023Article
- Long thrombus with a removed microaxial blood pump catheter 10 days after ECPELLA support.European heart journal. Case reports · 2023Article
- Temporary Mechanical Circulatory Support in Cardiogenic Shock Patients after Cardiac Procedures: Selection Algorithm and Weaning Strategies.Life (Basel, Switzerland) · 2023Article
- Mechanical circulatory support with ECMELLA approach in severe cardiogenic shock patients-state of the art.Journal of thoracic disease · 2023Article
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe benefit of prophylactic left ventricular (LV) unloading during venoarterial extracorporeal membrane oxygenation (VA-ECMO) in selected patients at risk of developing LV distension remains unclear.
methodsWe enrolled 136 patients treated with Impella pump decompression during VA-ECMO therapy for refractory cardiogenic shock. Patients were stratified by specific indication for LV unloading in the prophylactic vs. bail-out group. The bail-out unloading strategy was utilized to treat LV distension in VA-ECMO afterload-associated complications. The primary endpoint was all-cause 30-day mortality after VA-ECMO implantation. The secondary endpoint was successful myocardial recovery, transition to durable mechanical circulatory support (MCS), or heart transplantation.
resultsAfter propensity score matching, prophylactic unloading was associated with a significantly lower 30-day mortality risk (risk ratio 0.38, 95% confidence interval 0.23-0.62, and
conclusionsProphylactic unloading compared with the bail-out strategy may improve clinical outcomes in selected patients on VA-ECMO. Nevertheless, randomized trials are needed to validate these results.
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