Related Experiment Video

Updated: Jul 12, 2026

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
03:40

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting

Published on: January 17, 2025

National Practice Patterns of VA ECMO and Left Ventricular Mechanical Unloading for Cardiogenic Shock

Dustin M Anderson-Bell1, Morgan M Millar2, Rachel R Codden2

  • 1Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Department of Medicine, University of Utah Health, Salt Lake City, Utah, USA.

Artificial Organs
|July 9, 2026
PubMed

Insights

Management of cardiogenic shock (CS) with Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO) varies widely. This study reveals significant heterogeneity in VA ECMO use and Left Ventricular Mechanical Unloading (LVMU) strategies, highlighting the need for standardized approaches.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Mechanical Circulatory Support

Background:

  • Cardiogenic shock (CS) presents a significant clinical challenge with high morbidity.
  • Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO) is a key therapy for CS.
  • Optimal strategies for VA ECMO in CS, particularly regarding Left Ventricular Mechanical Unloading (LVMU), lack consensus.

Purpose of the Study:

  • To survey current practice patterns in the management of CS using VA ECMO.
  • To characterize the variability in VA ECMO implementation and LVMU strategies across institutions.

Main Methods:

  • A national survey was distributed to physicians managing VA ECMO for CS.
  • Data from 67 institutions were analyzed to assess practice variations.

Main Results:

  • VA ECMO was used for a median of 10% of CS patients.
  • Formal shock teams were present in 64.1% of centers, associated with higher VA ECMO volume.
  • LVMU was employed by 63.4% of centers, most frequently with Impella, but with wide variation in initiation timing and targets.

Conclusions:

  • Substantial heterogeneity exists in CS diagnosis, VA ECMO initiation, and LVMU strategies.
  • These findings underscore the necessity for prospective research to establish optimal patient care protocols.
Abstract

Keywords:
cardiogenic shockcritical careextracorporeal membrane oxygenationleft ventricular mechanical unloadingshock team

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