Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock (ECMO-CS) trial
The ECMO-CS trial was conducted to compare the effects of immediate implementation of VA-ECMO vs. an initially conservative therapy in patients with rapidly deteriorating or severe cardiogenic shock.
The primary endpoint was the composite of death from any cause, resuscitated circulatory arrest, and implementation of another mechanical circulatory support device at 30 days.
A total of 122 patients were randomized, and 117 subjects were included in the analysis after excluding 5 patients due to the absence of informed consent.
The composite primary endpoint occurred in 37 (63.8%) and 42 (71.2%) of patients in the immediate VA-ECMO and the no early VA-ECMO groups, respectively (hazard ratio, 0.72; 95% confidence intervals [CI], 0.46 to 1.12; P=0).
VA-ECMO was used in 23 (39%) of no early VA-OCO patients downstream due to worsening hemodynamic status..
Immediate implementation of VA-ECOMO did not improve clinical outcomes compared with an early conservative strategy that permitted downstream use if needed .
