Extracorporeal membrane oxygenation (ECMO) for cardiogenic shock after MI (ECLS-SHOCK trial)
When patients with massive myocardial infarctions develop cardiogenic shock, it’s a terrible sign. Even if they undergo rapid revascularization of the culprit lesion(s) with percutaneous coronary intervention (PCI) with stent placement, as many as half die within a month. Many of the rest are left with significant disability.
The traditional method to help support failing cardiac pump function during this period has been insertion of an intra-aortic balloon pump. But IABPs have been shown not to improve mortality in a large randomized trial (IABP-II). More recently, heart pumps like the Impella have been used, without high-quality evidence showing they help. (Unlike drugs, devices like Impella don’t have to show benefit in randomized trials to be FDA-approved for use.)
Centers that are well equipped for venoarterial extracorporeal membrane oxygenation (VA-ECMO, also called extracorporeal life support or ECLS) have increasingly deployed this therapy on patients in cardiogenic shock after…
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