ECMO management in cardiogenic shock-specialized versus non-cardiogenic shock-specialized centers: a registry-based analysis

Data on the impact of center specialization on extracorporeal membrane oxygenation (ECMO) management in cardiogenic shock (CS) remain limited. This study aimed to evaluate differences in outcomes and management of patients with CS receiving ECMO in CS-specialized versus non-CS-specialized centers. This registry-based study used data from the Chinese Society of Extracorporeal Life Support (CSECLS) registry. Adult patients diagnosed with CS and treated with ECMO were included. ECMO centers were categorized as CS-specialized or non-specialized based on the responsible department. Propensity score matching (PSM) was conducted to balance patient characteristics and center experience. The primary endpoint was in-hospital mortality. A total of 1,415 adult patients were included from January 1, 2017, to December 31, 2021 (523 in CS-specialized centers, 892 in non-CS-specialized centers). The mean age was 53.2 ± 16.1 years, and 30.3% of patients were female. In-hospital mortality was lower in CS-specialized centers both before (P = 0.001) and after adjustment (P = 0.035). Patients in CS-specialized centers more frequently received intra-aortic balloon pumps (38.5% vs. 30.4%; P = 0.009), and were less likely to require mechanical ventilation (80.6% vs. 90.7%; P < 0.001) or continuous renal replacement therapy (42.7% vs. 49.8%; P = 0.030) than those in non-CS-specialized centers. Treatment in CS-specialized centers was independently associated with lower in-hospital mortality among patients receiving ECMO for circulatory support, even after adjusting for both patient-level characteristics and center-level experience.

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Publication Details

Journal
BMC Anesthesiology
Published
2025-11-13
DOI
https://doi.org/10.1186/s12871-025-03450-y
Primary Topic
Mechanical Circulatory Support Devices
Type
article
Field-Weighted Citation Impact
0.00

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article

ECMO management in cardiogenic shock-specialized versus non-cardiogenic shock-specialized centers: a registry-based analysis

Jianling Liu, Xiaohui Hou, Xinrui Yu, Andong Lu et al.
BMC Anesthesiology
Mechanical Circulatory Support Devices
article

ECMO management in cardiogenic shock-specialized versus non-cardiogenic shock-specialized centers: a registry-based analysis

Jianling Liu, Xiaohui Hou, Xinrui Yu, Andong Lu, Hao Xing, Zhongtao Du, Y. Huang, Chenglong Li, Shuai Zhang, Sheng Zhang, Xiaomeng Wang, Yan Liu, Feng Yang, Liangshan Wang, Hong Wang, Miao‐Tzu Huang, Liwen Lyu, Liuer Zuo, Haixiu Xie, Ming Jia, Yiwen Wang
article en

Abstract

Data on the impact of center specialization on extracorporeal membrane oxygenation (ECMO) management in cardiogenic shock (CS) remain limited. This study aimed to evaluate differences in outcomes and management of patients with CS receiving ECMO in CS-specialized versus non-CS-specialized centers. This registry-based study used data from the Chinese Society of Extracorporeal Life Support (CSECLS) registry. Adult patients diagnosed with CS and treated with ECMO were included. ECMO centers were categorized as CS-specialized or non-specialized based on the responsible department. Propensity score matching (PSM) was conducted to balance patient characteristics and center experience. The primary endpoint was in-hospital mortality. A total of 1,415 adult patients were included from January 1, 2017, to December 31, 2021 (523 in CS-specialized centers, 892 in non-CS-specialized centers). The mean age was 53.2 ± 16.1 years, and 30.3% of patients were female. In-hospital mortality was lower in CS-specialized centers both before (P = 0.001) and after adjustment (P = 0.035). Patients in CS-specialized centers more frequently received intra-aortic balloon pumps (38.5% vs. 30.4%; P = 0.009), and were less likely to require mechanical ventilation (80.6% vs. 90.7%; P < 0.001) or continuous renal replacement therapy (42.7% vs. 49.8%; P = 0.030) than those in non-CS-specialized centers. Treatment in CS-specialized centers was independently associated with lower in-hospital mortality among patients receiving ECMO for circulatory support, even after adjusting for both patient-level characteristics and center-level experience.

BMC AnesthesiologyVol. 25(1)
Capital Medical University (CN), Anhui Medical University (CN), Wenzhou Medical University (CN), General Administration of Quality Supervision, Inspection and Quarantine (CN), Wuhan University (CN), Beijing Zhongke Science and Technology (China) (CN), The First People's Hospital of Shunde (CN), The People's Hospital of Guangxi Zhuang Autonomous Region (CN), Beijing Anzhen Hospital (CN), Beijing Institute of Water (CN), Wuhan Asia Heart Hospital (CN), First Affiliated Hospital of Anhui Medical University (CN), Second Affiliated Hospital of Zhejiang University (CN), First Hospital of Lanzhou University (CN), Beijing Aerospace Flight Control Center (CN), Southern Medical University (CN), Lanzhou University (CN), Guangzhou Medical University (CN)
Beijing Nova Program, National Key Research and Development Program of China
Openalex Percentile: Top 67%
Mechanical Circulatory Support Devices
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