Meta-analysis of the predictive value of critical care echocardiography for weaning outcomes in patients with VA-ECMO-assisted cardiogenic shock

The study analyzed the predictive value of echocardiographic parameters for successful weaning from venoarterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock. The research included 37 studies encompassing 3,458 patients. Aortic valve opening status demonstrated the best predictive ability (AUC = 0.88), followed by left ventricular outflow tract velocity-time integral (AUC = 0.85), tissue Doppler-derived mitral annular systolic velocity (AUC = 0.81), and left ventricular ejection fraction (AUC = 0.79). The study proposes provisional reference thresholds including ejection fraction of 20–25%, velocity-time integral ≥10 cm, and TAPSE ≥17 mm. These parameters should inform, but not replace, individualized clinical judgment in managing cardiogenic shock.