Work

VA-ECMO in high-risk pulmonary embolism: outcomes and role as bridge to recovery

Year: 2025

Type: article

Abstract: Background: High-risk pulmonary embolism (HRPE) with hemodynamic instability or cardiac arrest carries an in-hospital mortality rate of nearly 30%. VA-ECMO can stabilize acute RV failure and serve as a bridge to therapy or recovery. Due to the heterogeneous utilization of VA-ECMO in HRPE, its ideal application is uncertain. Methods: We retrospectively reviewed 28 HRPE patients meeting ESC/AHA criteria treated with VA-ECMO at a tertiary center (2017-2024). Clinical, procedural, and outcome data were analyzed, with comparisons between survivors and non-survivors to hospital discharge. Results: = 0.673). Conclusions: VA-ECMO achieved a 57.1% survival to discharge, consistent with prior studies. No significant survival differences were found between patients with or without cardiac arrest, pre-ECMO thrombolysis, or mobile versus in-hospital ECMO. Thrombolysis increased bleeding without improving outcomes. Mobile ECMO provided rapid support with comparable survival rates. Half the survivors recovered without adjunctive therapies, highlighting ECMO's role as a bridge to recovery. Larger studies are needed to optimize protocols.

Source: Resuscitation Plus

DOI: 10.1016/j.resplu.2025.101196

Authors: Shreya Arvind, Hilary Wagner, Chia-Ling Kuo, Kelin Zhong, Jason Gluck, Joseph Ingrassia

Institutions: University of Connecticut, UConn Health, Hartford Hospital

Language: English

Topic: Mechanical Circulatory Support Devices

Subfield: Biomedical Engineering

Field: Engineering

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,450