Veno-arterial extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock: rationale and design of the randomised, multicentre, open-label EURO SHOCK trial

Banning, Amerjeet; Adriaenssens, Tom; Berry, Colin; Bogaerts, Kris; Ērglis, Andrejs; Distelmaier, Klaus; Guagliumi, Giulio; Haine, Steven; Kastrati, Adnan; Maßberg, Steffen; Orban, Martin; Myrmel, Truls; Vuylsteke, Alain; Alfonso, Fernándo; Werf, Frans Van de; Verheugt, Freek W.A.; Flather, Marcus; Sabaté, Manel; Vrints, Christiaan J.; Gershlick, Anthony

doi:10.4244/eij-d-20-01076

Cited by 73 publications

(55 citation statements)

References 26 publications

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“…The most recognized trial in this field was the IABP‐SHOCK II trial, which showed no reduction in its primary outcome of 30‐day all‐cause mortality 36 . Use of intra‐aortic balloon pump decreased accordingly in the following years; nevertheless, scientific evidence for the growing application of veno‐arterial extracorporeal membrane oxygenation and percutaneous ventricular assist devices is even scarcer pending currently ongoing trials 2,5,37–39 …”

Section: Discussionmentioning

confidence: 99%

“…36 Use of intra-aortic balloon pump decreased accordingly in the following years; nevertheless, scientific evidence for the growing application of veno-arterial extracorporeal membrane oxygenation and percutaneous ventricular assist devices is even scarcer pending currently ongoing trials. 2,5,[37][38][39] Importantly, patient selection for all these therapies is a crucial aspect as it is likely that only a specific subgroup of CS patients will benefit from MCS devices. While patients with mild manifestation of CS might not be sick enough to benefit from MCS devices, they would still be at risk of life-threatening complications such as bleeding and ischaemic events.…”

Section: Rationale For Risk Stratification In Cardiogenic Shockmentioning

confidence: 99%

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Early risk stratification in patients with cardiogenic shock irrespective of the underlying cause – the Cardiogenic Shock Score

Beer

Jentzer

Weimann³

et al. 2022

European J of Heart Fail

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Section: Discussionmentioning

confidence: 99%

Section: Rationale For Risk Stratification In Cardiogenic Shockmentioning

confidence: 99%

Early risk stratification in patients with cardiogenic shock irrespective of the underlying cause – the Cardiogenic Shock Score

Beer

Jentzer

Weimann³

et al. 2022

European J of Heart Fail

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“…There are strong expectations around RCT focused on MCS in CS-AMI, i.e., EURO-SHOCK [46], ECLS-SHOCK [47] and DANGER Shock [48], ANCHOR [49], but the lessons learned from previous RCT should prepare us for a possible null result. In this sense, a global rethinking about the sources of evidence for CS therapy may be necessary.…”

Section: Discussionmentioning

confidence: 99%

Multitarget Approach to Cardiogenic Shock after Acute Myocardial Infarction: Extracorporeal Life Support (ECLS) and Beyond

2021

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Cardiogenic shock following acute myocardial infarction is associated with high mortality, substantially unchanged for the previous 20 years. Several approaches have been sought to achieve a therapeutic breakthrough, from myocardial revascularization strategies to the use of mechanical circulatory support. Many issues are, as yet, unresolved. Systemic inflammation seems to play a key role but is still lacking in effective therapies, and is potentially compounded by the death spiral of hypoperfusion and/or artificial devices. In this review, a multitarget approach to cardiogenic shock following acute myocardial infarction is proposed.

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“…The primary endpoint is 30-day mortality. In addition, analysis of the cost-effectiveness will be conducted [163]. Earlier cohort studies in patients with ACS complicated by refractory CS or cardiac arrest who were on ECMO, concluded that in-hospital survival rate was improved [164,165], and early initiation of ECMO would result in better outcomes and successful ECMO weaning [165].…”

Section: Nonpharmacologic Circulatory Supportmentioning

confidence: 99%

Current evidence in the diagnosis and management of cardiogenic shock complicating acute coronary syndrome

Kaddoura¹,

Elbdri²

2021

Rev. Cardiovasc. Med.

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Cardiogenic shock (CS) is a hemodynamically complex and highly morbid syndrome characterized by circulatory collapse and inadequate end-organ perfusion due to impaired cardiac output. It is usually associated with multiorgan failure and death. Mortality rate is still high despite advancement in treatment. CS has been conceptualised as a vicious cycle of injury and decompensation, both cardiac and systemic. Interrupting the vicious cycle and restoring the hemodynamic stability is a fundamental treatment of CS. Acute coronary syndrome (ACS) is the most frequent cause of CS. Early coronary revascularization is a cornerstone therapy that reduces mortality in patients with ACS complicated by CS. Early diagnosis of CS accompanied with invasive hemodynamics, helps in identification of CS phenotype, classification of CS severity, stratification of risk and prognostication. This can guide a tailored and optimized therapeutic approach. Inotropes and vasopressors are considered the firstline pharmacological option for hemodynamic instability. The current availability of the mechanical circulatory support devices has broadened the therapeutic choices for hemodynamic support. To date there is no pharmacological or nonpharmacological intervention for CS that showed a mortality benefit. The clinical practices in CS management remain inconsistent. Herein, this review discusses the current evidence in the diagnosis and management of CS complicating ACS, and features the changes in CS definition and classification.

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Veno-arterial extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock: rationale and design of the randomised, multicentre, open-label EURO SHOCK trial

Cited by 73 publications

References 26 publications

Early risk stratification in patients with cardiogenic shock irrespective of the underlying cause – the Cardiogenic Shock Score

Early risk stratification in patients with cardiogenic shock irrespective of the underlying cause – the Cardiogenic Shock Score

Multitarget Approach to Cardiogenic Shock after Acute Myocardial Infarction: Extracorporeal Life Support (ECLS) and Beyond

Current evidence in the diagnosis and management of cardiogenic shock complicating acute coronary syndrome

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