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{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:12:20Z","timestamp":1705623140350},"reference-count":93,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinik M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cardiogenic shock and cardiac arrest contribute pre-dominantly to mortality in acute cardiovascular care. Here, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as an established therapeutic option for patients suffering from these life-threatening entities. VA-ECMO provides temporary circulatory support until causative treatments are effective and enables recovery or serves as a bridging strategy to surgical ventricular assist devices, heart transplantation or decision-making. However, in-hospital mortality rate in this treatment population is still around 60%. In the recently published ARREST trial, VA-ECMO treatment lowered mortality rate in patients with ongoing cardiac arrest due to therapy refractory ventricular fibrillation compared to standard advanced cardiac life support in selected patients. Whether VA-ECMO can reduce mortality compared to standard of care in cardiogenic shock has to be evaluated in the ongoing prospective randomized studies EURO-SHOCK (NCT03813134) and ECLS-SHOCK (NCT03637205). As an innate drawback of VA-ECMO treatment, the retrograde aortic flow could lead to an elevation of left ventricular (LV) afterload, increase in LV filling pressure, mitral regurgitation, and elevated left atrial pressure. This may compromise myocardial function and recovery, pulmonary hemodynamics\u2014possibly with concomitant pulmonary congestion and even lung failure\u2014and contribute to poor outcomes in a relevant proportion of treated patients. To overcome these detrimental effects, a multitude of venting strategies are currently engaged for both preventive and emergent unloading. This review aims to provide a comprehensive and structured synopsis of existing venting modalities and their specific hemodynamic characteristics. We discuss in detail the available data on outcome categories and complication rates related to the respective venting option.<\/jats:p>\n <jats:p><jats:bold>Graphical abstract<\/jats:bold><\/jats:p>","DOI":"10.1007\/s00392-022-02069-0","type":"journal-article","created":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T05:02:50Z","timestamp":1660971770000},"page":"464-505","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Venting during venoarterial extracorporeal membrane oxygenation"],"prefix":"10.1007","volume":"112","author":[{"ORCID":"http:\/\/orcid.org\/0000-0002-3214-5672","authenticated-orcid":false,"given":"Enzo","family":"L\u00fcsebrink","sequence":"first","affiliation":[]},{"given":"Leonhard","family":"Binzenh\u00f6fer","sequence":"additional","affiliation":[]},{"given":"Antonia","family":"Kellnar","sequence":"additional","affiliation":[]},{"given":"Christoph","family":"M\u00fcller","sequence":"additional","affiliation":[]},{"given":"Clemens","family":"Scherer","sequence":"additional","affiliation":[]},{"given":"Benedikt","family":"Schrage","sequence":"additional","affiliation":[]},{"given":"Dominik","family":"Joskowiak","sequence":"additional","affiliation":[]},{"given":"Tobias","family":"Petzold","sequence":"additional","affiliation":[]},{"given":"Daniel","family":"Braun","sequence":"additional","affiliation":[]},{"given":"Stefan","family":"Brunner","sequence":"additional","affiliation":[]},{"given":"Sven","family":"Peterss","sequence":"additional","affiliation":[]},{"given":"J\u00f6rg","family":"Hausleiter","sequence":"additional","affiliation":[]},{"given":"Sebastian","family":"Zimmer","sequence":"additional","affiliation":[]},{"given":"Frank","family":"Born","sequence":"additional","affiliation":[]},{"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[]},{"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[]},{"given":"Andreas","family":"Sch\u00e4fer","sequence":"additional","affiliation":[]},{"given":"Christian","family":"Hagl","sequence":"additional","affiliation":[]},{"given":"Steffen","family":"Massberg","sequence":"additional","affiliation":[]},{"given":"Martin","family":"Orban","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"2069_CR1","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/S0140-6736(20)30733-9","volume":"396","author":"N Br\u00e9chot","year":"2020","unstructured":"Br\u00e9chot N, Hajage D, Kimmoun A et al (2020) Venoarterial extracorporeal membrane oxygenation to rescue sepsis-induced cardiogenic shock: a retrospective, multicentre, international cohort study. 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The other authors declare no conflict of interests. Andreas Sch\u00e4fer has received lecture fees and research support from Abiomed.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All ethical standards were met in writing and submitting this correspondence.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}} |