Kowalewski et al reported criteria for selecting an older adult with cardiogenic shock who may have a favorable prognosis with venoarterial extracorporeal life support. The authors are from multiple institutions participating in the Extracorporeal Life Support Organization Registry (ELSOR).

Patient selection: cardiogenic shock, age >= 70 years, cardiac arrest excluded, does not meet criteria for futilityor for guarded prognosis


Survival rate: up to 45%


Pre-implant predictors:

(1) age < 75 years

(2) shock duration of short duration

(3) expected duration of ECMO support < 96 hours

(4) during interventional procedure (PCI, TAVR, arrhythmia ablation)

(5) blood lactate < 6 mmol/L

(6) no major comorbidities

(7) no severe peripheral vascular disease

(8) not post-cardiotomy (except heart transplant)

(9) SAPS II < 87

(10) APACHE II <= 37

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