Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review

Abstract Background Acute lung injury and acute respiratory failure are frequent complications of cardiogenic shock and are associated with increased morbidity and mortality. Even with increased use of temporary mechanical circulatory support, such as venoarterial extracorporeal membrane oxygenation...

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Main Authors: Akram M. Zaaqoq, Michael A. Mazzeffi, Melissa A. Vogelsong, Mark Roeser, Sung-Min Cho
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04472-7
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author Akram M. Zaaqoq
Michael A. Mazzeffi
Melissa A. Vogelsong
Mark Roeser
Sung-Min Cho
author_facet Akram M. Zaaqoq
Michael A. Mazzeffi
Melissa A. Vogelsong
Mark Roeser
Sung-Min Cho
author_sort Akram M. Zaaqoq
collection DOAJ
description Abstract Background Acute lung injury and acute respiratory failure are frequent complications of cardiogenic shock and are associated with increased morbidity and mortality. Even with increased use of temporary mechanical circulatory support, such as venoarterial extracorporeal membrane oxygenation (VA-ECMO), acute lung injury related to cardiogenic shock continues to have a determinantal effect on patient outcomes. Objectives To summarize potential mechanisms of acute lung injury described in patients with cardiogenic shock supported by VA-ECMO and determine current knowledge gaps. Methods We searched literature from January 1st, 2010, to December 31st, 2023, using MEDLINE, EMBASE, and Web of Science databases on February 27th, 2024. The search strategy was split into two main domains: (a) cardiogenic shock and ECMO and (b) Acute respiratory failure and ECMO. Results The search yielded 2246 citations. After 743 duplicates were removed, 1465 citations remained. Of these studies, 1456 were excluded based on the exclusion criteria, leaving the final eight studies we included in our scoping review. We identified disruption of the pulmonary blood flow in patients with cardiogenic shock, with cardiac arrest being an extreme form of cardiogenic shock. Placing the patient on VA-ECMO could intensify this process of lung injury. Conclusion Acute lung injury in patients with cardiogenic shock, especially when supported by VA ECMO, is a significant complication that is associated with increased morbidity and mortality. There is a limited understanding of the underlying mechanisms that could represent opportunities for future research to mitigate its development and provide the best approach to protecting and monitoring lung function.
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spelling doaj-art-9745fea8cf584b59bf6b9aa7d8894daa2025-01-26T12:14:22ZengBMCBMC Cardiovascular Disorders1471-22612025-01-012511810.1186/s12872-025-04472-7Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping reviewAkram M. Zaaqoq0Michael A. Mazzeffi1Melissa A. Vogelsong2Mark Roeser3Sung-Min Cho4Department of Anesthesiology, Division of Critical Care, University of VirginiaDepartment of Anesthesiology, Division of Critical Care, University of VirginiaDepartment of Anesthesiology, Division of Cardiac Anesthesia, Stanford UniversityDepartment of Surgery, Division of Cardiac Surgery, University of VirginiaDepartment of Surgery, Division of Cardiac Surgery, Johns Hopkins School of MedicineAbstract Background Acute lung injury and acute respiratory failure are frequent complications of cardiogenic shock and are associated with increased morbidity and mortality. Even with increased use of temporary mechanical circulatory support, such as venoarterial extracorporeal membrane oxygenation (VA-ECMO), acute lung injury related to cardiogenic shock continues to have a determinantal effect on patient outcomes. Objectives To summarize potential mechanisms of acute lung injury described in patients with cardiogenic shock supported by VA-ECMO and determine current knowledge gaps. Methods We searched literature from January 1st, 2010, to December 31st, 2023, using MEDLINE, EMBASE, and Web of Science databases on February 27th, 2024. The search strategy was split into two main domains: (a) cardiogenic shock and ECMO and (b) Acute respiratory failure and ECMO. Results The search yielded 2246 citations. After 743 duplicates were removed, 1465 citations remained. Of these studies, 1456 were excluded based on the exclusion criteria, leaving the final eight studies we included in our scoping review. We identified disruption of the pulmonary blood flow in patients with cardiogenic shock, with cardiac arrest being an extreme form of cardiogenic shock. Placing the patient on VA-ECMO could intensify this process of lung injury. Conclusion Acute lung injury in patients with cardiogenic shock, especially when supported by VA ECMO, is a significant complication that is associated with increased morbidity and mortality. There is a limited understanding of the underlying mechanisms that could represent opportunities for future research to mitigate its development and provide the best approach to protecting and monitoring lung function.https://doi.org/10.1186/s12872-025-04472-7Cardiogenic shockAcute respiratory failureLung injuryExtracorporeal membrane oxygenation
spellingShingle Akram M. Zaaqoq
Michael A. Mazzeffi
Melissa A. Vogelsong
Mark Roeser
Sung-Min Cho
Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review
BMC Cardiovascular Disorders
Cardiogenic shock
Acute respiratory failure
Lung injury
Extracorporeal membrane oxygenation
title Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review
title_full Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review
title_fullStr Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review
title_full_unstemmed Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review
title_short Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review
title_sort lung injury in myocardial infarction associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation a scoping review
topic Cardiogenic shock
Acute respiratory failure
Lung injury
Extracorporeal membrane oxygenation
url https://doi.org/10.1186/s12872-025-04472-7
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