Evidence map›Paper›PMID 39494489›Full record

SynthesisArtificial organs2025

Early left ventricular unloading during extracorporeal membrane oxygenation in cardiogenic shock: A systematic review and meta-analysis.

Mohamed Abuelazm, Ahmad Nawlo, Ahmed A Ibrahim, Ahmed Mazen Amin, Abdelrahman Mahmoud, Salem Elshenawy, Yasmeen Jamal Alabdallat, Mustafa Turkmani, Basel Abdelazeem, Marco Caccamo

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Artificial organs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mohamed AbuelazmFaculty of Medicine, Tanta University, Tanta, Egypt.
Ahmad NawloDivision of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Ahmed A IbrahimFaculty of Medicine, Menoufia University, Menoufia, Egypt.
Ahmed Mazen AminFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Abdelrahman MahmoudFaculty of Medicine, Minia University, Minia, Egypt.
Salem ElshenawyFaculty of Medicine, Alexandria University, Alexandria, Egypt.ORCID https://orcid.org/0000-0001-8164-4358
Yasmeen Jamal AlabdallatFaculty of Medicine, Hashemite University, Amman, Jordan.
Mustafa TurkmaniFaculty of Medicine, Michigan State University, East Lansing, Michigan, USA.ORCID https://orcid.org/0009-0001-4261-0638
Basel AbdelazeemDepartment of Cardiology, West Virginia University, Morgantown, West Virginia, USA.ORCID https://orcid.org/0000-0002-2919-6196
Marco CaccamoDepartment of Cardiology, West Virginia University, Morgantown, West Virginia, USA.ORCID https://orcid.org/0000-0001-8534-0474

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeft ventricular (LV) unloading is a crucial intervention to decrease the harmful consequences of extracorporeal membrane oxygenation (ECMO) on hemodynamic status in cardiogenic shock (CS) patients. However, a lingering question preoccupies experts: Should we intervene early or wait until clinical deterioration caused by increasing afterload is detected?

methodsA systematic review and meta-analysis synthesizing studies, which were retrieved by systematically searching PubMed, Web of Science, SCOPUS, and Cochrane through December 2023. We used R V. 4.3 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42024501643.

resultsEight studies with 2.117 patients were included. Early/prophylactic LV unloading was associated with a lower incidence of all-cause mortality [RR: 0.87 with 95% CI (0.79, 0.95), p < 0.01]. However, there was no significant difference between the two groups regarding cardiac mortality [RR: 1.01 with 95% CI (0.68, 1.48), p = 0.98], non-cardiac mortality [RR: 0.86 with 95% CI (0.46, 1.62), p = 0.64], and in-hospital mortality [RR: 0.95 with 95% CI (0.86, 1.05), p = 0.30]. There was no significant difference between the two groups regarding ECMO weaning, myocardial recovery, ECMO duration, and length of hospitalization.

conclusionEarly/prophylactic LV unloading during ECMO for CS patients was associated with a decreased incidence of all-cause mortality and sepsis or infection, with no effect on ECMO weaning, myocardial recovery, ECMO duration, and hospital length of stay.

Indexed as

Extracorporeal Membrane OxygenationShock, CardiogenicVentricular Function, LeftHumansclinical trialECMOLV unloadingmeta‐analysisreviewshock

Identifiers

PMID39494489
PMCPMC11974487

What OpenQuestion holds

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Registered trials

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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.