{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:56:23Z","timestamp":1786542983688,"version":"build-2736575974"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"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. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitor (ICI)-associated myocarditis is a rare but potentially fatal immune-related adverse event that can rapidly progress to life-threatening arrhythmias and cardiogenic shock, often necessitating mechanical circulatory support. Extracorporeal membrane oxygenation (ECMO) has emerged as a critical life-saving intervention in such cases. However, the role of ECMO in treating ICI-associated myocarditis remains underexplored, with limited literature available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present a case of fulminant ICI-associated myocarditis with cardiogenic shock successfully managed with ECMO. Additionally, we review and summarize data from 13 ECMO-assisted patients with ICI-associated myocarditis to provide insights into the clinical characteristics, management strategies, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main results<\/jats:title>\n                    <jats:p>Among the 13 patients (with a mean age 59.08 years), monotherapy using nivolumab or pembrolizumab represented the predominant ICI treatment regimen. The median treatment cycle was 3.0 (IQR: 2.0 ~ 7.0), and the median duration from first administration to myocarditis onset was 77.0 (IQR: 20.5 ~ 250.0) days. The median duration of myocarditis symptoms was 19.0 (IQR: 15.5 ~ 42.5) days. Common presenting symptoms included fever and dyspnea, while most patients exhibited elevated myocardial enzymes and BNP levels, arrhythmias, and an average left ventricular ejection fraction (LVEF) of 38.31% at admission. Myocardial biopsy was the primary diagnostic method. In addition to immunosuppressive therapy, most patients also required intra-aortic balloon pump (IABP) support. The median duration of ECMO and IABP support was 9.0 (IQR: 6.5 ~ 15.5) days and 11.5 (IQR: 7.5 ~ 13.0) days, respectively. Ultimately, nine of the thirteen patients (69.23%) survived.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our analysis demonstrates ECMO\u2019s potential as a bridge-to-recovery strategy for severe ICI-associated myocarditis with cardiogenic shock. The observed survival rate of 69.23% supports its judicious use in conjunction with prompt immunosuppression. Prospective studies are warranted to optimize ECMO initiation criteria, duration, and combination strategies with other circulatory support modalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1646040","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:29:17Z","timestamp":1765175357000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Successful ECMO support for cardiogenic shock induced by immune checkpoint inhibitor-associated myocarditis: a case report and literature 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