{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:42:33Z","timestamp":1740166953819,"version":"3.37.3"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Echocardiography is critical in the management of patients supported with veno-arterial extracorporeal membrane oxygenation (V-A ECMO). This study aimed to identify the incidence of critical echocardiographic findings and determine their prognostic significance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>All available echocardiograms, hemodynamic variables and outcomes of patients with CS supported with V-A in the period of 2011-2018 at the Toronto General Hospital were retrospectively reviewed. Critical echocardiographic findings were defined as minimal to no left ventricular (LV) ejection, the presence of intra-cardiac clot, significant pericardial effusion and malpositioning of ECMO cannulae. 130 patients were included in this study with in-hospital mortality of 58.5%. Critical findings were most often seen in the first echocardiogram (42\/121; 35%). The incidence of critical findings in the first echocardiogram was minimal to no LV ejection in 28 patients (23%), intracardiac thromboses in 8 patients (6.6%), tamponade in 5 patients (4%) and malpositioned cannulae in 1 patient (0.8%). Presence of a critical finding in the first study was associated with an odds ratio for in-hospital mortality of 2.32 (95% CI 1.01-5.06, P = 0.011).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The initial echocardiogram was most likely to demonstrate a critical finding of which the most common was minimal to no LV ejection. Critical echocardiographic findings carried prognostic significance for in-hospital mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuad038","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T18:54:32Z","timestamp":1681412072000},"page":"391-395","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic echocardiographic findings in patients supported with venoarterial extracorporeal membrane oxygenation for cardiogenic shock"],"prefix":"10.1093","volume":"12","author":[{"given":"Maithri","family":"Siriwardena","sequence":"first","affiliation":[{"name":"Department of Medicine, The Prince Charles Hospital , Rode Road, Chermside, Queensland 4032 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darshan H","family":"Brahmbhatt","sequence":"additional","affiliation":[{"name":"Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network , 585 University Ave, MaRS 9th floor 9083, Toronto, Ontario M5G 2N2 , Canada"},{"name":"Division of Cardiology, Department of Medicine, University of Toronto , 585 University Avenue, Toronto, Ontario M5G 2N2 , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghislaine","family":"Doufl\u00e9","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care, University of Toronto , 585 University Ave, 9-MaRS-9013 Toronto, Ontario M5G 2N2 , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eddy","family":"Fan","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care, University of Toronto , 585 University Ave, 9-MaRS-9013 Toronto, Ontario M5G 2N2 , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2824-1215","authenticated-orcid":false,"given":"Filio","family":"Billia","sequence":"additional","affiliation":[{"name":"Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network , 585 University Ave, MaRS 9th floor 9083, Toronto, Ontario M5G 2N2 , Canada"},{"name":"Division of Cardiology, Department of Medicine, University of Toronto , 585 University Avenue, Toronto, Ontario M5G 2N2 , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"2023060210072975600_zuad038-B1","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1038\/nrcardio.2016.96","article-title":"Management of refractory cardiogenic shock","volume":"13","author":"Reyentovich","year":"2016","journal-title":"Nat Rev Cardiol"},{"key":"2023060210072975600_zuad038-B2","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1053\/jpsu.2002.32254","article-title":"Intraoperative ultrasound reduces ECMO catheter malposition requiring surgical correction","volume":"37","author":"Kuenzler","year":"2002","journal-title":"J Pediatr Surg"},{"volume-title":"Extracorporeal Life Support: The ELSO Red Book","year":"2017","author":"Brogan","key":"2023060210072975600_zuad038-B3"},{"key":"2023060210072975600_zuad038-B4","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.jcmg.2016.05.004","article-title":"Safety and feasibility of contrast echocardiography for ECMO evaluation","volume":"10","author":"Bennett","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023060210072975600_zuad038-B5","doi-asserted-by":"crossref","first-page":"2246","DOI":"10.1093\/eurheartj\/ehv194","article-title":"Predicting survival after ECMO for refractory cardiogenic shock: the survival after veno-arterial-ECMO (SAVE)-score","volume":"36","author":"Schmidt","year":"2015","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal: Acute Cardiovascular Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjacc\/advance-article-pdf\/doi\/10.1093\/ehjacc\/zuad038\/50059988\/zuad038.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjacc\/article-pdf\/12\/6\/391\/50508035\/zuad038.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjacc\/article-pdf\/12\/6\/391\/50508035\/zuad038.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T21:25:44Z","timestamp":1685741144000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjacc\/article\/12\/6\/391\/7117817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":5,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,4,13]]},"published-print":{"date-parts":[[2023,6,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjacc\/zuad038","relation":{},"ISSN":["2048-8726","2048-8734"],"issn-type":[{"type":"print","value":"2048-8726"},{"type":"electronic","value":"2048-8734"}],"subject":[],"published-other":{"date-parts":[[2023,6]]},"published":{"date-parts":[[2023,4,13]]}}}