Have we averted deaths using venoarterial ECMO?
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock in adults is currently the quickest and cheapest way to obtain biventricular heart–lung support at the bedside . The precise incidence of VA-ECMO is not well understood and varies by country. However, the increasing use of VA-ECMO has been well documented throughout the world [2, 3]. The epidemiology of VA-ECMO has been best characterized in Germany, where the incidence of VA-ECMO increased substantially from 96 cases in 2007 (incidence 0.1:100,000) to 2873 cases (3.5:100,000) in 2014, a 35-fold increase in use during that time . Importantly, with such extraordinary growth in use coupled with persistent high mortality, we must begin to understand: Is VA-ECMO saving lives? One way to measure this is by calculating the number of deaths averted by using VA-ECMO.
However, it is worth noting that this trend is supported more by clinician beliefs than by high-level scientific evidence—currently,...
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