ECLS-SHOCK
Extracorporeal Life Support in Infarct-Related Cardiogenic Shock
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 420 patients with acute MI complicated by cardiogenic shock, VA-ECMO did not reduce 30-day mortality versus standard care, with more bleeding and vascular complications.
N
420
Schéma
Multicentre RCT, Germany/Slovenia
Critère
30-day all-cause mortality
Pertinence
2
Résultat47.8% vs 49.0% (RR 0.98; 95% CI 0.80–1.19; p=0.81). BARC 3–5 bleeding 23.4% vs 9.6%. 1-y mortality 55.0% vs 55.8%.
Thiele H, et al. N Engl J Med. 2023;389(14):1286-1297. 10.1056/NEJMoa2307227
Discussion et critique
Largest VA-ECMO trial; no benefit and clear bleeding harm. Reserve VA-ECMO for refractory biventricular failure.