{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T15:49:01Z","timestamp":1793029741673,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,6,16]],"date-time":"2024-06-16T00:00:00Z","timestamp":1718496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Cardiogenic shock (CS) develops in up to 10% of patients with acute myocardial infarction (AMI) and carries a 50% risk of mortality. Despite the paucity of evidence regarding its benefits, venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used in clinical practice in patients with AMI in CS (AMI-CS). This review aims to provide an in-depth description of the four available randomized controlled trials to date designed to evaluate the benefit of VA-ECMO in patients with AMI-CS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The literature search was conducted on PubMed, Google Scholar, and clinicaltrials.gov to identify the four relevant randomized control trials from years of inception to October 2023. Despite differences in patient selection, nuances in trial conduction, and variability in trial endpoints, all four trials (ECLS-SHOCK I, ECMO-CS, EUROSHOCK, and ECLS-SHOCK) failed to demonstrate a mortality benefit with the use of VA-ECMO in AMI-CS, with high rates of device-related complications. However, the outcome of these trials is nuanced by the limitations of each study that include small sample sizes, challenging patient selection, and high cross-over rates to the intervention group, and lack of use of left ventricular unloading strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The presented literature of VA-ECMO in CS does not support its routine use in clinical practice. We have yet to identify which subset of patients would benefit most from this intervention. This review emphasizes the need for designing adequately powered trials to properly assess the role of VA-ECMO in AMI-CS, in order to build evidence for best practices.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeae051","type":"journal-article","created":{"date-parts":[[2024,6,16]],"date-time":"2024-06-16T15:30:46Z","timestamp":1718551846000},"source":"Crossref","is-referenced-by-count":5,"title":["The use of venoarterial extracorporeal membrane oxygenation in cardiogenic shock: a narrative review"],"prefix":"10.1093","volume":"4","author":[{"given":"Tara","family":"G\u00e9d\u00e9on","sequence":"first","affiliation":[{"name":"Division of Cardiology, Jewish General Hospital, McGill University , 3755 C\u00f4te Ste-Catherine Road, Suite H-421.1, Montreal, QC H3T 1E2 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetiana","family":"Zolotarova","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital , 3755 C\u00f4te Ste-Catherine Road, Montreal, QC H3T 1E2 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1296-0661","authenticated-orcid":false,"given":"Mark J","family":"Eisenberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Jewish General Hospital, McGill University , 3755 C\u00f4te Ste-Catherine Road, Suite H-421.1, Montreal, QC H3T 1E2 , Canada"},{"name":"Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital , 3755 C\u00f4te Ste-Catherine Road, Montreal, QC H3T 1E2 , Canada"},{"name":"Department of Medicine, McGill University , 1001 Decarie Boulevard, Suite D05-2212, Montreal, QC H4A 3J1 , Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University , 2001 McGill College Ave, Montreal, QC H3A 1Y7 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,16]]},"reference":[{"key":"2024083006210812600_oeae051-B1","doi-asserted-by":"crossref","first-page":"e232","DOI":"10.1161\/CIR.0000000000000525","article-title":"Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association","volume":"136","author":"van Diepen","year":"2017","journal-title":"Circulation"},{"key":"2024083006210812600_oeae051-B2","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1056\/NEJM199908263410901","article-title":"Early revascularization in acute myocardial infarction complicated by cardiogenic shock. 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