[Open questions with respect to extracorporeal circulatory support 2024]

Area of Science:

• Cardiology
• Critical Care Medicine
• Cardiovascular Surgery

Background:

• Extracorporeal circulatory support (ECS) offers life-saving interventions for cardiogenic shock and resuscitation.
• However, significant questions remain regarding optimal patient selection and treatment strategies.

Purpose of the Study:

• To highlight the critical unanswered questions surrounding the application of extracorporeal circulatory support.
• To emphasize the need for defined inclusion/exclusion criteria and optimized treatment protocols.

Main Methods:

• This review synthesizes current knowledge and identifies gaps in the evidence base for ECS.
• It underscores the necessity for large-scale, multicenter, randomized studies and registries.

Main Results:

• Current criteria for ECS use are not universally defined, impacting treatment efficacy and resource allocation.
• The viability of ECS programs may depend on local capabilities, such as achieving specific low-flow times.
• Optimal management strategies, including left ventricular unloading, require further investigation.

Conclusions:

• Careful consideration and further research are essential before widespread implementation of ECS.
• Standardized protocols and robust data collection through multicenter studies are crucial for advancing ECS therapy.