• Curr Cardiol Rep · Aug 2018

    Review Meta Analysis

    ECMO and Short-term Support for Cardiogenic Shock in Heart Failure.

    • Mathew Jose Chakaramakkil and Cumaraswamy Sivathasan.
    • Department of Cardiothoracic Surgery, Level 12, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore. mathew.jose.c@singhealth.com.sg.
    • Curr Cardiol Rep. 2018 Aug 16; 20 (10): 87.

    Purpose Of ReviewThis review aims to discuss the role of ECMO in the treatment of cardiogenic shock in heart failure.Recent FindingsTrials done previously have shown that IABP does not improve survival in cardiogenic shock compared to medical treatment, and that neither Impella 2.5 nor TandemHeart improves survival compared to IABP. The "IMPRESS in severe shock" trial compared Impella CP with IABP and found no difference in survival. A meta-analysis of cohort studies comparing ECMO with IABP showed 33% improved 30-day survival with ECMO (risk difference 33%; 95% CI 14-52%; p = 0.0008; NNT 3). ECMO is indicated in medically refractory cardiogenic shock. ECMO can be considered in cardiogenic shock patients with estimated mortality of more than 50%. ECMO is probably the MCS of choice in cardiogenic shock with; biventricular failure, respiratory failure, life-threatening arrhythmias and cardiac arrest.

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