{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:17:30Z","timestamp":1787163450411,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":397,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to investigate incidence and predictors of weaning failure and in-hospital death after successful weaning from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Overall, 685 patients with CS treated with VA-ECMO from 23 tertiary care centres in 7 countries were analysed (median age 57 [interquartile range 49\u201366] years, 542 [79.1%] male, median lactate 7.6 [interquartile range 4.1\u201312.7] mmol\/L). The cause of CS was acute myocardial infarction in 438 (63.9%) patients, and 431 (62.9%) patients presented with cardiac arrest. A total of 410 patients (59.9%) were successfully weaned from VA-ECMO, whereas in 275 patients (40.1%) weaning failed (i.e. patients died on or within 48\u2009h after VA-ECMO support). Of the successfully weaned patients, 150 (36.6%) died before hospital discharge. On multivariable logistic regression, predictors for both patient groups varied: age (per 10\u2009years, odds ratio [OR] 1.49, 95% confidence interval [CI] 1.25\u20131.76; p\u2009&amp;lt;\u20090.001) and cardiac arrest before VA-ECMO implantation (OR 1.64, 95% CI 1.01\u20132.64; p\u2009=\u20090.04) were associated with weaning failure, whereas lactate clearance within 24\u2009h after VA-ECMO initiation was associated with successful weaning (OR 0.21, 95% CI 0.1\u20130.44; p\u2009&amp;lt;\u20090.001). In-hospital death after successful weaning was more likely with higher age (per 10\u2009years, OR 1.56, 95% CI 1.24\u20131.97; p\u2009&amp;lt;\u20090.001), renal replacement therapy (OR 2.56, 95% CI 1.4\u20134.68; p\u2009=\u20090.002) and bleeding events (OR 2.93, 95% CI 1.4\u20136.14; p\u2009=\u20090.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Weaning from VA-ECMO fails in 40% of patients treated with VA-ECMO for CS. When successful, survival after VA-ECMO weaning mostly depends on age and the incidence of device- and shock-related complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3583","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T12:35:23Z","timestamp":1737117323000},"page":"832-841","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Incidence and Predictors of Weaning Failure From Veno-Arterial Extracorporeal Membrane Oxygenation Therapy in Patients With Cardiogenic Shock"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0992-0236","authenticated-orcid":false,"given":"Angela","family":"Dettling","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Kellner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Sundermeyer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt N.","family":"Beer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Besch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia Fausta","family":"Bertoldi","sequence":"additional","affiliation":[{"name":"Cardio Center, Humanitas Clinical and Research Center \u2013 IRCCS , Rozzano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]},{"name":"Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"Dauw","sequence":"additional","affiliation":[{"name":"Cariovascular Center Aalst, OLV Hospital , Aalst ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Eckner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Paracelsus Medical University N\u00fcrnberg , N\u00fcrnberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Eitel","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]},{"name":"University Heart Center L\u00fcbeck, University Hospital Schleswig-Holstein , L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Graf","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]},{"name":"University Heart Center L\u00fcbeck, University Hospital Schleswig-Holstein , L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Horn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf , Duesseldorf ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Jozwiak-Nozdrzykowska","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Science , Leipzig ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulus","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site Hamburg\/Kiel\/L\u00fcbeck , Hamburg ,","place":["Germany"]},{"name":"Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Kluge","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Department of Intensive Care Medicine , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannis","family":"Krais","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Medical Center Regensburg , Regensburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"von Lewinski","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Linke","sequence":"additional","affiliation":[{"name":"Department for Internal Medicine and Cardiology, Technische Universit\u00e4t Dresden, Heart Centre Dresden, University Hospital , Dresden ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Luedike","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen , Essen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzo","family":"L\u00fcsebrink","sequence":"additional","affiliation":[{"name":"Department of Medicine I, University Hospital, LMU Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nordbeck","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital W\u00fcrzburg , W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Pappalardo","sequence":"additional","affiliation":[{"name":"Department 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