• Vincenza Caruso, Vivien Berthoud, Olivier Bouchot, Maxime Nguyen, Belaid Bouhemad, Pierre-Grégoire Guinot, and ECMOVIS Study Group.
• Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France.
• J. Cardiothorac. Vasc. Anesth. 2024 Mar 1; 38 (3): 724730724-730.

ObjectivesThe authors investigated the role of early venoarterial extracorporeal membrane oxygenation (VA ECMO) implantation in patients with postcardiotomy cardiogenic shock (PCS) on mortality and morbidity when integrating vasoactive-inotropic score (VIS) and type of catecholamine support.DesignA retrospective, multicenter, observational study with propensity-weight matching.SettingFour university-affiliated intensive care units.ParticipantsPatients with PCS in the operating room.InterventionsEarly VA ECMO support.Measurements And Main ResultsOf 2,742 patients screened during the study period, 424 (16%) patients were treated with inotropic drugs, and 75 (3%) patients were supported by VA ECMO in the operating room. Patients supported by VA ECMO had a higher use of vasopressor and inotropic drugs, with a higher VIS score. After propensity matching (integrating VIS and catecholamines type), mortality (56% v 20%, p < 0.001) and morbidity (cardiac, renal, transfusion) were higher in patients supported by VA ECMO than in a matched control group.ConclusionsWhen matching integrated the pre-ECMO VIS and the type of catecholamines, VA ECMO remained associated with high mortality and morbidity, suggesting that VIS alone should not be used as a main determinant of VA ECMO implantation.Copyright © 2023 Elsevier Inc. All rights reserved.

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