SynthesisFrontiers in medicine2026
Meta-analysis of the predictive value of critical care echocardiography for weaning outcomes in patients with VA-ECMO-assisted cardiogenic shock.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
Objective: This study aimed to evaluate the predictive value of critical care echocardiographic parameters for weaning outcomes in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock. Methods: A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, Web of Science, Scopus, and CINAHL from inception to December 2025. Studies reporting echocardiographic predictors of VA-ECMO weaning outcomes were included. A two-component analytical approach was applied, which pooled standardized mean differences for association analyses and used bivariate random-effects modeling (Reitsma method) for diagnostic accuracy. Results: A total of 37 studies encompassing 3,458 patients were analyzed. Aortic valve opening status exhibited the highest discriminative ability (AUC = 0.88, 95% CI: 0.82-0.93), followed by left ventricular outflow tract velocity-time integral (AUC = 0.85, 95% CI: 0.81-0.88), tissue Doppler-derived mitral annular systolic velocity (AUC = 0.81, 95% CI: 0.76-0.86), and left ventricular ejection fraction (AUC = 0.79, 95% CI: 0.75-0.83). Provisional reference thresholds, derived primarily from studies using a 48-h decannulation definition, included LVEF 20-25%, LVOT-VTI ≥ 10 cm, and TAPSE ≥17 mm; these should be interpreted as exploratory rather than confirmatory. Conclusion: This meta-analysis describes a hierarchy of echocardiographic parameters for predicting VA-ECMO weaning success and provides provisional reference thresholds that may inform-but do not replace - individualized clinical judgment in cardiogenic shock management.
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