[Cardiogenic shock assisted with venoarterial extracorporeal membrane oxygenation: experience of an Argentine institution].

INTRODUCTION

Cardiogenic shock carries a mortality rate of 40-50%. In cases that progress unfavorably despite pharmacological treatment, ventricular assist devices such as venoarterial extracorporeal membrane oxygenation play a prominent role. Although two recent controlled clinical trials have been published, the primary source of information remains observational studies, which are notably scarce in Argentina.

MATERIALS AND METHODS

A retrospective cohort study was conducted, including patients from January 2012 to April 2023 with refractory cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation. Their baseline characteristics, clinical course, and acute versus chronic presentation were analyzed.

RESULTS

61 patients were supported with venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock. 51% were supported as a bridge to cardiac transplantation. 84% of the patients were in INTERMACS grades 1 or 2 at the time of support initiation. The assisted patients had a survival rate of 44%, similar to results reported by the Extracorporeal Life Support Organization. The most frequent complications were renal replacement therapy (46%) and sepsis (38%). Patients with acute presentation had better survival outcomes.

DISCUSSION

Venoarterial extracorporeal membrane oxygenation support is a valid therapy for refractory cardiogenic shock unresponsive to conventional treatments. Experience in Argentina is limited. In this study, survival rates align with international registries, highlighting the therapy's significant value in our institution. Acute presentation of cardiogenic shock correlates with improved survival outcomes.