Recent conventional clinical trials have not convincingly shown the superiority of V-A ECMO in acute myocardial infarction complicated by cardiogenic shock as compared with medical therapy alone. Though, it has repeatedly been reported that the addition of interventional left ventricular unloading to V-A ECMO may improve clinical outcome. Novel approaches such as registry-based adaptive platform trials and computational physiological modeling are now introduced to inform clinicians by aiming to better account for patient-specific variation and complexity inherent to V-A ECMO and have raised a widespread interest. To provide modern high-quality V-A ECMO care, it remains essential to understand the patient's pathophysiology and the intricate interaction of an individual patient with extracorporeal circulatory support devices. Innovative clinical trial design and computational modeling approaches carry great potential towards advanced clinical decision support in ECMO and related critical care.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- left ventricular
- clinical trial
- acute myocardial infarction
- respiratory failure
- clinical decision support
- healthcare
- heart failure
- case report
- palliative care
- hypertrophic cardiomyopathy
- mechanical ventilation
- left atrial
- percutaneous coronary intervention
- mitral valve
- phase ii
- intensive care unit
- study protocol
- pain management
- risk assessment
- double blind
- affordable care act
- acute coronary syndrome