Extracorporeal life support in cardiogenic shock: impact of acute versus chronic etiology on outcome

The authors retrospectively analyze outcomes for patients placed on ECMO for cardiogenic shock, and separately analyze the patients depending on whether the ECMO support was for isolated acute cardiogenic shock or for acute-upon-chronic cardiogenic shock.  Over a 4-year period, 37 (58%) patients fell into the isolated acute category, and 27 (42%) in the acute-upon-chronic category.  Overall 30-day survival was 80%, with a hospital discharge rate of 59%.  Not surprisingly, the only patients who recovered cardiac function were in the isolated acute group.  The acute-upon-chronic category required bridging, either to heart transplantation or mechanical circulatory support.