Impact of Left Ventricular Venting on Acute Brain Injury in Patients With Cardiogenic Shock: An Extracorporeal Life Support Organization Registry Analysis
Main finding · ABI (hypoxic-ischemic brain injury, ischemic stroke, or intracranial hemorrhage)Result — go to the resultAdjusted odds ratio 1.67 95% CI 1.22–2.26Authors' conclusion
LV venting was associated with increased odds of ABI but not mortality in patients receiving peripheral venoarterial ECMO for cardiogenic shock. There was no difference in odds of ABI or mortality for IABP vs. mAFP patients.
Study context
- Population
- Adults on peripheral venoarterial extracorporeal membrane oxygenation (ECMO) for cardiogenic shock, Extracorporeal Life Support Organization registry (2013–2024)525 (4.0%) had acute brain injury (ABI)
- Participants
- 13,276 adults
- Exposure
- Left ventricular (LV) venting vs no LV venting; Intra-aortic balloon pump (IABP) vs microaxial flow pump (mAFP)
- LV ventingn = 1,456
- mAFPn = 231reference
- IABPn = 231
- Outcome
- Acute brain injury (hypoxic-ischemic brain injury, ischemic stroke, or intracranial hemorrhage)
Methodological detailsmultivariable logistic regression, propensity-score matched (mAFP vs IABP), registry analysis
- Multivariable logistic regression
- Propensity-score matched (mAFP vs IABP)
- Registry analysis
Main finding
As reported in the abstract
ABI (hypoxic-ischemic brain injury, ischemic stroke, or intracranial hemorrhage)
Adjusted odds ratio
1.67
95% CI 1.22–2.26
P = 0.001
LV-vented vs non-LV-vented
aOR 1.67 (95% CI 1.22–2.26); P = 0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Hospital mortalityLV-vented vs non-LV-vented · multivariable logistic regression | 1.07 (0.90–1.27) | P = 0.45 | |
| ABI, IABP vs mAFP (propensity-matched cohort)n = 231 per group · propensity-matched cohort | 1.35 (0.69–2.71) | P = 0.39 | |
| Hospital mortality, IABP vs mAFP (propensity-matched cohort)n = 231 per group · propensity-matched cohort | 0.88 (0.58–1.31) | P = 0.52 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Original publication
Impact of Left Ventricular Venting on Acute Brain Injury in Patients With Cardiogenic Shock: An Extracorporeal Life Support Organization Registry Analysis. Crit Care Med. Published 17 October 2025. doi:10.
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