{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:55:51Z","timestamp":1785545751686,"version":"3.56.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"Background<\/jats:title>Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used in patients with refractory cardiogenic shock (CS) or out-of-hospital cardiac arrest. It is difficult to perform VA-ECMO weaning, which may cause circulatory failure and death. Levosimendan is an effective inotropic agent used to maintain cardiac output, has a long-lasting effect, and may have the potential benefit for VA-ECMO weaning. The study aimed to explore the relationship between the early use of levosimendan and the rate of VA-ECMO weaning failure in patients on VA-ECMO support for circulatory failure.<\/jats:p><\/jats:sec>Methods<\/jats:title>All patients who underwent VA-ECMO in our hospital for CS between January 2017 and December 2020 were recruited in this cohort study and divided into two groups: without and with levosimendan use. Levosimendan was used as an add-on to other inotropic agents as early as possible after VA-ECMO setting. The primary endpoint was VA-ECMO weaning success, which was defined as survival without events for 24 h after VA-ECMO withdrawl. The secondary outcomes were cardiovascular and all-cause mortality at the 30-day and 180-day follow-up periods post-VA-ECMO initialization.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 159 patients were recruited for our study; 113 patients were enrolled in the without levosimendan-use group and 46 patients were enrolled in the levosimendan-use group. In levosimendan-use group, the patients received levosimendan infusion within 24 h after VA-ECMO initialization. Similar hemodynamic parameters were noted between the two groups. Poorer left ventricular ejection fraction and a higher prevalence of intra-aortic balloon pumping were observed in the levosimendan group. An improved weaning rate (without vs. with: 48.7 vs. 82.6%; p<\/jats:italic> &lt; 0.001), lower in-hospital mortality rate (without vs. with: 68.1 vs. 43.5%; p<\/jats:italic> = 0.007), and 180-day cardiovascular mortality (without vs. with: 75.3 vs. 43.2%; p<\/jats:italic> &lt; 0.001) were also noted. Patients administered with levosimendan also presented a lower rate of 30-day (without vs. with: 75.3 vs. 41.3%; p<\/jats:italic> = 0.034) and 180-day (without vs. with: 77.0 vs. 43.2%; p<\/jats:italic> &lt; 0.001) all-cause mortality.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Early levosimendan administration may contribute to increasing the success rate of VA-ECMO weaning and may help to decrease CV and all-cause mortality.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.912321","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T05:37:41Z","timestamp":1656567461000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Early Levosimendan Administration Improved Weaning Success Rate in Extracorporeal Membrane Oxygenation in Patients With Cardiogenic Shock"],"prefix":"10.3389","volume":"9","author":[{"given":"Yu-Wen","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chieh","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Jui","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiu-Yu","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Nan","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huang-Chung","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Shen","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Hsun","family":"Sung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh-Ho","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Jung","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"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":"B2","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.011991","article-title":"Cardiogenic shock.","volume":"8","author":"Vahdatpour","year":"2019","journal-title":"J Am Heart Assoc."},{"key":"B3","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1080\/21556660.2021.1930548","article-title":"Vasoactive pharmacologic therapy in cardiogenic shock: a critical review.","volume":"10","author":"Kaddoura","year":"2021","journal-title":"J Drug Assess."},{"key":"B4","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.healun.2012.10.005","article-title":"Clinical outcome of mechanical circulatory support for refractory cardiogenic shock in the current era.","volume":"32","author":"Takayama","year":"2013","journal-title":"J Heart Lung Transplant."},{"key":"B5","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.118.004905","article-title":"Venoarterial extracorporeal membrane oxygenation for cardiogenic shock and cardiac arrest.","volume":"11","author":"Rao","year":"2018","journal-title":"Circ Heart Fail."},{"key":"B6","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.healun.2021.01.009","article-title":"Mortality in patients with cardiogenic shock supported with VA ECMO: a systematic review and meta-analysis evaluating the impact of etiology on 29,289 patients.","volume":"40","author":"Alba","year":"2021","journal-title":"J Heart Lung Transplant."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.1053\/j.jvca.2018.03.016","article-title":"Clinical outcomes of adult patients who receive extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock: a systematic review and meta-analysis.","volume":"32","author":"Wang","year":"2018","journal-title":"J Cardiothorac Vasc Anesth."},{"key":"B8","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1164\/rccm.201609-1945OC","article-title":"Eunice Kennedy Shriver national institute of child health and human development collaborative pediatric critical care research network. 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