What question did this study set out to answer?

This study aims to evaluate how implementing a shock team affects outcomes for STEMI patients requiring VA-ECMO.

February 6, 2026

Impact of shock team implementation on outcomes of patients withSTEMI requiring veno-arterial extracorporeal membrane oxygenation as mechanical circulatory support

Key Points

This study aims to evaluate how implementing a shock team affects outcomes for STEMI patients requiring VA-ECMO.
Retrospective data review from April 30, 2017, to December 31, 2024.
Patients divided into two groups based on shock team implementation.
Comparison of baseline characteristics and outcomes between groups.
Significant reduction in time from CPR to VA-ECMO cannulation from 64 ± 28 minutes to 25 ± 12 minutes (p<0.001).
In-hospital mortality decreased from 76% to 22.7% (p<0.001).
Other outcomes showed clinical significance but were not statistically significant due to small sample size.

Abstract

Abstract Background This retrospective study evaluates the impact of implementing a shock team on the outcomes of patients with ST-segment elevation myocardial infarction (STEMI) requiring Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) as mechanical circulatory support. These patients represent a high-risk group with high mortality rates. However, there is no data from the region to clarify the impact of the shock team on these outcomes Methods Data were reviewed from April 30, 2017, to December 31, 2024. Patients were divided into two groups: 25 patients treated before the shock team implementation (April 30, 2017, to May 31, 2023) and 22 patients managed by shock team (June 1, 2023, to December 31, 2024). Baseline characteristics and outcomes were compared between the two groups. Results A total of 47 patients were included in the study. The mean age was 49 ± 8 years, with no significant difference between the groups (p=0.495). All patients underwent primary percutaneous coronary intervention (PCI). The time from CPR to VA-ECMO cannulation significantly decreased from 64 ± 28 minutes to 25 ± 12 minutes after shock team (p0.001). In-hospital mortality significantly decreased from 76% to 22.7%(p0.001). Other outcomes, such as time to VA-ECMO decannulation, time to extubation, length of hospital stay, and VA-ECMO access complications, showed a clinical significance however not statistically significant difference due to the small sample size. Conclusion The implementation of a shock team significantly increased the utilisation of VA-ECMO, due to implementation of standardized management protocol which lead to early identification of the high-risk patients and early activation of the team before patients' arrival to the ED as well as daily follow up by the same team which reduced the time to VA-ECMO cannulation and improved the in-hospital mortality in patients with STEMI requiring VA-ECMO. These findings suggest that a dedicated shock team with standardized management protocol can enhance the management and outcomes of these critically ill patients. Outcomes

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