ArticleCardiovascular drugs and therapy2025
Control of Cardiac Output with Ivabradine or Beta-Blockers for Refractory Hypoxemia under Veno-Venous ECMO for Severe ARDS.
Article in Cardiovascular drugs and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Refractory Hypoxemia under Veno- veous ECMO: Oxygen Transport Goes Beyond the Capillaries.Cardiovascular drugs and therapy · 2025Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeHypoxemia is a risk factor for mortality and long-term neuropsychological impairment during severe acute respiratory distress syndrome (ARDS). Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a potential treatment for such cases but may not suffice. We aimed to evaluate the effects of pharmacological interventions for cardiac output (CO) control using ivabradine or beta-blockers for refractory hypoxemia during VV-ECMO.
methodsThe study involved retrospective analysis of consecutive patients with severe ARDS who underwent VV-ECMO at a tertiary university hospital between March 2020 and May 2022. Patients with refractory hypoxemia under VV-ECMO were included. Pharmacological interventions included ivabradine and/or short half-life beta-blockers. The primary endpoint was the change in ECMO flow/CO ratio and secondary endpoints were changes in macrocirculation (mean arterial pressure), oxygenation [arterial saturation (SaO
resultsOut of 70 patients on VV-ECMO, ten had refractory hypoxemia under VV-ECMO and received pharmacological interventions to control CO. The ECMO flow/CO ratio significantly increased with pharmacological intervention overall (from 60% [50-66] to 69% [61-81], p = 0.02), as well as with beta-blockers or ivabradine individually. However, DO
conclusionIvabradine and beta-blockers were clinically well-tolerated and improved the ECMO flow/CO ratio in patients with refractory hypoxemia during VV-ECMO. However, the improvement of arterial oxygenation was associated with decreased DO
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