Higher inotrope exposure during VA ECMO linked to weaning failure

This observational cohort study across six Dutch hospitals examined 440 adults receiving venoarterial ECMO for cardiogenic shock between 2018 and 2024. Using joint modeling of cumulative inotropic scores, the study reported that higher cumulative inotropic exposure during ECMO support was associated with increased risk of ECMO weaning failure, 30-day mortality, arrhythmias, and protracted lactate clearance. The authors noted that inotropic support was often maintained at similar levels after ECMO initiation and called for prospective studies to assess whether tapering inotropes could improve cardiac recovery.

Most relevant for: Adult patients with refractory cardiogenic shock supported on venoarterial ECMO.

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