Interventional procedure overview of VA ECMO for postcardiotomy cardiogenic shock in adults
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Appendix A: Methods and literature search strategy
Methods and literature search strategy
NICE has identified studies and reviews relevant to venoarterial extracorporeal membrane oxygenation (VA ECMO) in the following indications from the medical literature:
acute heart failure in adults
extracorporeal cardiopulmonary resuscitation (ECPR) in adults in refractory cardiac arrest
postcardiotomy cardiogenic shock in adults.
The search was initially developed for the acute heart failure indication only (Tables 4a and 4b) and then modified and updated to cover the additional two indications (Table 4c).
Search strategy design and peer review
This search report is informed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S).
A NICE information specialist ran the literature searches for acute heart failure in adults on 18th September 2024 and updated them on 12th May 2025. The search strategy was modified and updated on 19th June 2025 to incorporate the 2 additional interventions. See the search strategy history for the full search strategy for each database. Relevant published studies identified during consultation or resolution that are published after this date may also be considered for inclusion.
The principal search strategy was developed in MEDLINE ALL (Ovid interface). It was adapted for use in each of the databases listed in table 4a, taking into account the database's size, search functionality and subject coverage. The MEDLINE ALL strategy was quality assured by a NICE senior information specialist. All translated search strategies were peer reviewed to ensure their accuracy. The quality assurance and peer review procedures were adapted from the Peer Review of Electronic Search Strategies (PRESS) 2015 evidence-based checklist.
Review management
The search results were managed in EPPI‑Reviewer version 5 (EPPI‑R5). Duplicates were removed in EPPI‑R5 using a 2‑step process. First, automated deduplication was done using a high-value algorithm. Second, manual deduplication was used to assess low-probability matches. All decisions about inclusion, exclusion and deduplication were recorded and stored.
Limits and restrictions
The CENTRAL database search removed trial registry records and conference material. The Embase search excluded conference material, letters and editorial. We excluded the following publication types in MEDLINE: letter, historical article, comment, editorial, news and case reports. English language limits were applied to the search when possible in the database.
The search was limited from March 2013 to the latest update. The date limit was included to update searches undertaken for an earlier version of this guidance.
The limit to remove animal studies in the searches is standard NICE practice, which has been adapted from Dickersin K, Scherer R, Lefebvre C (1994) Systematic Reviews: Identifying relevant studies for systematic reviews. BMJ 309(6964): 1286.
Main search
Table 4a Main search results
Database | Date searched | Database platform | Database segment or version | Number of results downloaded |
Cochrane Central Register of Controlled Trials (CENTRAL) | 18/09/24 | Wiley | Issue 8 of 12, August 2024 | 410 |
Cochrane Database of Systematic Reviews (CDSR) | 20/09/24 | Wiley | Issue 9 of 12, September 2024 | 13 |
Embase | 20/09/24 | Ovid | 1974 to 2024 September 17 | 2101 |
INAHTA International HTA Database | 18/09/24 | https://database.inahta.org/ | - | 24 |
MEDLINE ALL | 18/09/24 | Ovid | 1946 to Sept 17, 2024 | 1454 |
Update search
Table 4b Update search results 1
Database | Date searched | Database platform | Database segment or version | Number of results downloaded |
Cochrane Central Register of Controlled Trials (CENTRAL) | 12/05/2025 | Wiley | Issue 4 of 12, April 2025 | 39 |
Cochrane Database of Systematic Reviews (CDSR) | 12/05/2025 | Wiley | Issue 5 of 12, May 2025 | 0 |
Embase | 12/05/2025 | Ovid | 1974 to 2025 May 09 | 54 |
INAHTA International HTA Database | 12/05/2025 | https://database.inahta.org/ | 4 | |
MEDLINE ALL | 12/05/2025 | Ovid | 1946 to May 09, 2025 | 195 |
Additional update search
Table 4c Update search results 2
This version of the search was modified to include two additional indications and searched from March 2013 to latest update.
Database | Date searched | Database platform | Database segment or version | Number of results downloaded |
Cochrane Central Register of Controlled Trials (CENTRAL) | 19/06/25 | Wiley | Issue 6 of 12, 2025 | 295 |
Cochrane Database of Systematic Reviews (CDSR) | 19/05/25 | Wiley | Issue 6 of 12, 2025. | 0 |
Embase | 19/06/25 | Ovid | 1974 to 2025 June 17 | 4461 |
INAHTA International HTA Database | 19/06/25 | https://database.inahta.org/ | - | 29 |
MEDLINE ALL | 19/06/25 | Ovid | 1946 to June 18, 2025 | 4707 |
Search strategy history – initial search strategy September 2024
MEDLINE ALL search strategy
1 , Heart Failure/th , 29,868
2 , Acute disease/th , 1,194
3 , 1 and 2 , 11
4 , *Cardiomyopathies/th , 1,150
5 , *Shock cardiogenic/th , 2,135
6 , Myocardial Stunning/th [Therapy] , 155
7 , Myocarditis/th [Therapy] , 1,294
8 , *Myocardial infarction/ , 138,977
9 , Out-of-Hospital Cardiac Arrest/th [Therapy] , 5,734
10 , ((acute* or server*) adj (heart* or cardiac* or myocard* or cardio* or ventric*) adj (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock*)).ti,ab. , 9,513
11 , Myocardit*.ti,ab. , 21,440
12 , ((Postpartum* or post-parttum* or peripartum* or peri-partum*) adj cardiomyopath*).ti,ab. , 1,697
13 , PPCM.ti,ab. , 671
14 , (myocard* adj (stun* or hibernat* or infract*)).ti,ab. , 2,258
15 , Primary Graft Dysfunction/th [Therapy] , 99
16 , (primary* adj graft* adj dysfunct*).ti,ab. , 1,392
17 , or/3-16 , 182,062
18 , *Cardiopulmonary Resuscitation/mt [Methods] , 4,116
19 , *Extracorporeal Membrane Oxygenation/ , 13,895
20 , ECMO.ti. , 3,217
21 , *Extracorporeal Circulation/mt [Methods] , 1,090
22 , (extracorp* adj circulat*).ti,ab. , 8,596
23 , (extracorp* adj ((cardiopulmon* adj resuscitat*) or CPR)).ti,ab. , 1,229
24 , ECPR.ti. , 154
25 , (Biomedicus adj pump*).ti,ab. , 45
26 , (Maquet* adj rotaflow*).ti,ab. , 12
27 , (jostra adj (pump* or rotaflow*)).ti,ab. , 5
28 , (levitronix adj (centrimag* or pump* or system* or oxygen*)).ti,ab. , 54
29 , (Medos adj (Hilite* or oxygen*)).ti,ab. , 22
30 , left ventricle assist device.ti,ab. , 106
31 , or/18-30 , 28,477
32 , 17 and 31 , 2,725
33 , animals/ not human/ , 5,225,551
34 , 32 not 33 , 2,680
35 , limit 34 to english language , 2,503
36 , limit 35 to ed=20130331-20240930 , 2,028
37 , limit 36 to (letter or historical article or comment or editorial or news or case reports) , 574
38 , 36 not 37 , 1,454
[Embase] search strategy
1 , heart failure/th [Therapy] , 15,752
2 , acute disease/th [Therapy] , 2,395
3 , 1 and 2 , 10
4 , *cardiomyopathy/th [Therapy] , 1,144
5 , *cardiogenic shock/th [Therapy] , 2,129
6 , stunned heart muscle/th [Therapy] , 53
7 , myocarditis/th [Therapy] , 864
8 , *heart infarction/ , 110,365
9 , primary graft dysfunction/th [Therapy] , 94
10 , "out of hospital cardiac arrest"/th [Therapy] , 3,862
11 , ((acute* or server*) adj (heart* or cardiac* or myocard* or cardio* or ventric*) adj (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock*)).ti,ab. , 17,537
12 , Myocardit*.ti,ab. , 31,093
13 , ((Postpartum* or post-parttum* or peripartum* or peri-partum*) adj cardiomyopath*).ti,ab. , 2,835
14 , PPCM.tw. , 1,261
15 , (myocard* adj (stun* or hibernat* or infract*)).ti,ab. , 3,555
16 , (primary* adj graft* adj dysfunct*).tw. , 3,009
17 , or/3-16 , 173,201
18 , *resuscitation/ , 60,473
19 , *extracorporeal oxygenation/ , 16,545
20 , ECMO.ti. , 7,837
21 , *extracorporeal circulation/ , 9,094
22 , (extracorp* adj circulat*).ti,ab. , 9,683
23 , (extracorp* adj ((cardiopulmon* adj resuscitat*) or CPR)).ti,ab. , 1,851
24 , ECPR.ti. , 352
25 , (Biomedicus adj pump*).ti,ab. , 50
26 , (Maquet* adj rotaflow*).ti,ab. , 31
27 , (jostra adj (pump* or rotaflow*)).ti,ab. , 16
28 , (levitronix adj (centrimag* or pump* or system* or oxygen*)).ti,ab. , 150
29 , (Medos adj (Hilite* or oxygen*)).ti,ab. , 44
30 , left ventricle assist device.ti,ab. , 217
31 , or/18-30 , 96,434
32 , 17 and 31 , 5,350
33 , Nonhuman/ not Human/ , 5,532,522
34 , 32 not 33 , 5,275
35 , limit 34 to letter/ or (letter or editorial).pt. , 2,165,352
36 , 34 not 35 , 4,904
37 , limit 36 to dc=20130331-20240930 , 3,599
38 , limit 37 to english language , 3,481
39 , (conference abstract* or conference review or conference paper or conference proceeding).db,pt,su. , 6,020,541
40 , 38 not 39 , 2,101
Cochrane Library (CDSR) search strategy
#1 MeSH descriptor: [Heart Failure] explode all trees and with qualifier(s): [therapy - TH] 2591
#2 MeSH descriptor: [Acute Disease] explode all trees and with qualifier(s): [therapy - TH] 118
#3 #1 and #2 0
#4 MeSH descriptor: [Cardiomyopathies] explode all trees and with qualifier(s): [therapy - TH] 248
#5 MeSH descriptor: [Shock, Cardiogenic] explode all trees and with qualifier(s): [therapy - TH] 177
#6 MeSH descriptor: [Myocardial Stunning] explode all trees and with qualifier(s): [therapy - TH] 3
#7 MeSH descriptor: [Myocarditis] explode all trees and with qualifier(s): [therapy - TH] 13
#8 MeSH descriptor: [Myocardial Infarction] explode all trees and with qualifier(s): [therapy - TH] 3337
#9 MeSH descriptor: [Primary Graft Dysfunction] explode all trees and with qualifier(s): [therapy - TH] 3
#10 MeSH descriptor: [Out-of-Hospital Cardiac Arrest] explode all trees and with qualifier(s): [therapy - TH] 539
#11 ((acute* or server*) near/1 (heart* or cardiac* or myocard* or cardio* or ventric*) near/1 (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock*)) 2663
#12 Myocardit* 1421
#13 (Postpartum* or post-partum* or peripartum* or peri-partum*) near/1 cardiomyopath* 47
#14 PPCM 39
#15 (myocard* near/1 (stun* or hibernat* or infract*)) 342
#16 (primary* near/1 graft* near dysfunct*) 146
#17 #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 8646
#18 MeSH descriptor: [Cardiopulmonary Resuscitation] this term only 1688
#19 MeSH descriptor: [Extracorporeal Membrane Oxygenation] this term only 361
#20 ECMO 1101
#21 MeSH descriptor: [Extracorporeal Circulation] this term only and with qualifier(s): [methods - MT] 120
#22 (extracorp* near/1 circulat*) 1423
#23 (extracorp* near/1 ((cardiopulmon* near resuscitat*) or CPR)) 71
#24 ECPR 112
#25 (Biomedicus near/1 pump*) 3
#26 (Maquet* rotaflow*) 3
#27 jostra near/1 (pump* or rotaflow*) 1
#28 (levitronix near/1 (centrimag* or pump* or system* or oxygen*)) 0
#29 Medos near/1 (Hilite* or oxygen*) 0
#30 left ventricle assist device 219
#31 #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 4577
#32 #17 AND #31 494
#33 "conference":pt or (clinicaltrials or trialsearch):so 777352
#34 #32 NOT #33 with Cochrane Library publication date Between Mar 2013 and Sep 2024, in Cochrane Reviews 13
Cochrane Library CENTRAL search strategy
#1 MeSH descriptor: [Heart Failure] explode all trees and with qualifier(s): [therapy - TH] 2591
#2 MeSH descriptor: [Acute Disease] explode all trees and with qualifier(s): [therapy - TH] 118
#3 #1 and #2 0
#4 MeSH descriptor: [Cardiomyopathies] explode all trees and with qualifier(s): [therapy - TH] 248
#5 MeSH descriptor: [Shock, Cardiogenic] explode all trees and with qualifier(s): [therapy - TH] 177
#6 MeSH descriptor: [Myocardial Stunning] explode all trees and with qualifier(s): [therapy - TH] 3
#7 MeSH descriptor: [Myocarditis] explode all trees and with qualifier(s): [therapy - TH] 13
#8 MeSH descriptor: [Myocardial Infarction] explode all trees and with qualifier(s): [therapy - TH] 3337
#9 MeSH descriptor: [Primary Graft Dysfunction] explode all trees and with qualifier(s): [therapy - TH] 3
#10 MeSH descriptor: [Out-of-Hospital Cardiac Arrest] explode all trees and with qualifier(s): [therapy - TH] 539
#11 ((acute* or server*) near/1 (heart* or cardiac* or myocard* or cardio* or ventric*) near/1 (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock*)) 2663
#12 Myocardit* 1421
#13 (Postpartum* or post-partum* or peripartum* or peri-partum*) near/1 cardiomyopath* 47
#14 PPCM 39
#15 (myocard* near/1 (stun* or hibernat* or infract*)) 342
#16 (primary* near/1 graft* near dysfunct*) 146
#17 #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 8646
#18 MeSH descriptor: [Cardiopulmonary Resuscitation] this term only 1688
#19 MeSH descriptor: [Extracorporeal Membrane Oxygenation] this term only 361
#20 ECMO 1101
#21 MeSH descriptor: [Extracorporeal Circulation] this term only and with qualifier(s): [methods - MT] 120
#22 (extracorp* near/1 circulat*) 1423
#23 (extracorp* near/1 ((cardiopulmon* near resuscitat*) or CPR)) 71
#24 ECPR 112
#25 (Biomedicus near/1 pump*) 3
#26 (Maquet* rotaflow*) 3
#27 jostra near/1 (pump* or rotaflow*) 1
#28 (levitronix near/1 (centrimag* or pump* or system* or oxygen*)) 0
#29 Medos near/1 (Hilite* or oxygen*) 0
#30 left ventricle assist device 219
#31 #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 4577
#32 #17 AND #31 494
#33 "conference":pt or (clinicaltrials or trialsearch):so 777352
#34 #32 NOT #33 with Cochrane Library publication date Between Mar 2013 and Sep 2024, in Trials 410
INAHTA HTA Database search strategy
1 , "Heart Failure"[mh] , 252
2 , "Acute Disease"[mh] , 46
3 , #2 AND #1 , 2
4 , "Cardiomyopathies"[mh] , 21
5 , "Shock, Cardiogenic"[mh] , 11
6 , "Myocardial Stunning"[mh] , 1
7 , "Myocarditis"[mh] , 1
8 , "Myocardial Infarction"[mh] , 123
9 , "Out-of-Hospital Cardiac Arrest"[mh] , 10
10 , ((acute* or server*) and (heart* or cardiac* or myocard* or cardio* or ventric*) and (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock*)). , 149
11 , Myocardit* , 5
12 , ((Postpartum* or post-parttum* or peripartum* or peri-partum*) AND cardiomyopath*) , 1
13 , PPCM , 0
14 , (myocard* and (stun* or hibernat* or infract*)) , 2
15 , "Primary Graft Dysfunction"[mh] , 0
16 , (primary* AND graft* AND dysfunct*). , 3
17 , #16 OR #15 OR #14 OR #13 OR #12 OR #11 OR #10 OR #9 OR #8 OR #7 OR #6 OR #5 OR #4 OR #3 , 291
18 , "Cardiopulmonary Resuscitation"[mh] , 23
19 , "Extracorporeal Membrane Oxygenation"[mh] , 29
20 , ECMO , 31
21 , "Extracorporeal Circulation"[mh] , 9
22 , (extracorp* AND circulat*). , 13
23 , (extracorp* AND ((cardiopulmon* AND resuscitat*) or CPR)) , 8
24 , ECPR , 4
25 , (Biomedicus AND pump*). , 0
26 , Maquet* and rotaflow*) , 0
27 , (jostra and (pump* or rotaflow*)). , 0
28 , (levitronix AND (centrimag* or pump* or system* or oxygen*)). , 0
29 , (Medos AND (Hilite* or oxygen*)). , 0
30 , left ventricle assist device , 3
31 , #30 OR #29 OR #28 OR #27 OR #26 OR #25 OR #24 OR #23 OR #22 OR #21 OR #20 OR #19 OR #18 , 74
32 , #31 AND #17 , 24
Search strategy history – update search strategy June 2026
This version of the search was modified to include two additional indications and searched from March 2013 to latest update.
MEDLINE ALL search strategy
1, Heart Failure/th [Therapy], 31,048
2, Acute Disease/th [Therapy], 1,222
3, 1 and 2, 11
4, *Cardiomyopathies/th, 1,952
5, *Shock, Cardiogenic/th, 2,922
6, Myocardial Stunning/th [Therapy], 155
7, Myocarditis/th [Therapy], 1,333
8, *Myocardial infarction/th [Therapy], 19,394
9, Out-of-Hospital Cardiac Arrest/th [Therapy], 6,031
10, ((acute* or severe* or refract*) adj (heart* or cardiac* or myocard* or cardio* or ventric*) adj (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock* or arrest* or stunn*)).tw., 18,262
11, (cardiogen* adj shock).tw., 17,331
12, Myocardit*.tw., 22,410
13, ((Postpartum* or post-partum* or peripartum* or peri-partum*) adj cardiomyopath*).tw., 1,811
14, (postcardiotomy or Post-cardiotomy).tw., 1,230
15, PPCM.tw., 717
16, (myocard* adj (stun* or hibernat* or infarct*)).tw., 241,791
17, Primary Graft Dysfunction/th [Therapy], 109
18, (primary* adj graft* adj dysfunct*).tw., 1,543
19, or/3-18, 301,507
20, *Cardiopulmonary Resuscitation/mt [Methods], 5,700
21, *Extracorporeal Membrane Oxygenation/, 14,654
22, ECMO.tw., 14,889
23, *Extracorporeal Circulation/mt, 1,259
24, (extracorp* adj circulat*).tw., 8,706
25, (extracorp* adj ((cardiopulmon* adj resuscitat*) or CPR)).tw., 1,377
26, ECPR.ti,ab., 1,006
27, (Biomedicus adj pump*).tw., 45
28, (Maquet* adj rotaflow*).tw., 12
29, (jostra adj (pump* or rotaflow*)).tw., 5
30, (levitronix adj (centrimag* or pump* or system* or oxygen*)).tw., 54
31, (Medos adj (Hilite* or oxygen*)).tw., 22
32, (left adj ventricle adj assist adj device).tw., 107
33, or/20-32, 35,941
34, 19 and 33, 6,390
35, animals/ not humans/, 5,314,500
36, 34 not 35, 6,296
37, (exp child/ or exp pediatrics/ or exp infant/ or exp adolescent/) not (exp adult/ or exp middle age/ or exp aged/), 2,281,857
38, 36 not 37, 5,768
39, limit 38 to english language, 5,398
40, limit 39 to ed=20130901-20250630, 3,883
41, limit 39 to dt=20130901-20250630, 4,610
42, 40 or 41, 4,707
EMBASE search strategy
1, heart failure/th [Therapy], 15,823
2, acute disease/th [Therapy], 2,430
3, 1 and 2, 10
4, *cardiomyopathy/th [Therapy], 1,155
5, *cardiogenic shock/th [Therapy], 2,198
6, stunned heart muscle/th [Therapy], 53
7, myocarditis/th [Therapy], 874
8, *heart infarction/th [Therapy], 9,266
9, "out of hospital cardiac arrest"/th [Therapy], 3,990
10, ((acute* or severe* or refract*) adj (heart* or cardiac* or myocard* or cardio* or ventric*) adj (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock* or arrest* or stunn*)).tw., 32,685
11, (cardiogen* adj shock).tw., 33,626
12, Myocardit*.tw., 33,287
13, ((Postpartum* or post-partum* or peripartum* or peri-partum*) adj cardiomyopath*).tw., 3,113
14, (postcardiotomy or Post-cardiotomy).tw., 2,079
15, PPCM.tw., 1,382
16, (myocard* adj (stun* or hibernat* or infarct*)).tw., 360,780
17, primary graft dysfunction/th [Therapy], 94
18, (primary* adj graft* adj dysfunct*).tw., 3,390
19, or/3-18, 448,325
20, *resuscitation/, 62,739
21, *extracorporeal oxygenation/, 18,275
22, ECMO.tw., 32,585
23, *extracorporeal circulation/, 9,325
24, (extracorp* adj circulat*).tw., 10,199
25, (extracorp* adj ((cardiopulmon* adj resuscitat*) or CPR)).tw., 2,110
26, ECPR.tw., 2,050
27, (Biomedicus adj pump*).tw., 50
28, (Maquet* adj rotaflow*).tw., 33
29, (jostra adj (pump* or rotaflow*)).tw., 17
30, (levitronix adj (centrimag* or pump* or system* or oxygen*)).tw., 154
31, (Medos adj (Hilite* or oxygen*)).tw., 46
32, (left adj ventricle adj assist adj device).tw., 230
33, or/20-32, 115,373
34, 19 and 33, 15,247
35, Nonhuman/ not Human/, 5,720,207
36, 34 not 35, 14,988
37, (conference abstract* or conference review or conference paper or conference proceeding).db,pt,su., 6,294,375
38, 36 not 37, 6,986
39, (exp child/ or exp pediatrics/ or exp adolescent/) not exp adult/, 2,766,023
40, 38 not 39, 6,431
41, limit 40 to english language, 5,795
42, limit 41 to dd=20130901-20250630, 4,668
43, limit 41 to dc=20130901-20250630, 4,655
44, 42 or 43, 4,669
45, Clinical trial.pt., 533,511
46, 44 not 45, 4,461
Cochrane Library (CDSR) search strategy
#1 MeSH descriptor: [Heart Failure] this term only and with qualifier(s): [therapy - TH] 2567
#2 MeSH descriptor: [Acute Disease] this term only and with qualifier(s): [therapy - TH] 115
#3 #1 and #2 0
#4 MeSH descriptor: [Cardiomyopathies] this term only and with qualifier(s): [therapy - TH] 86
#5 MeSH descriptor: [Shock, Cardiogenic] this term only and with qualifier(s): [therapy - TH] 194
#6 MeSH descriptor: [Myocardial Stunning] this term only and with qualifier(s): [therapy - TH] 3
#7 MeSH descriptor: [Myocarditis] this term only and with qualifier(s): [therapy - TH] 13
#8 MeSH descriptor: [Myocardial Infarction] this term only and with qualifier(s): [therapy - TH] 2729
#9 MeSH descriptor: [Out-of-Hospital Cardiac Arrest] this term only and with qualifier(s): [therapy - TH] 568
#10 ((acute* or severe*or refract*) next (heart* or cardiac* or myocard* or cardio* or ventric*) next (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock* or arrest* or stunn*)) 2872
#11 (cardiogen* next shock) 1767
#12 Myocardit* 1473
#13 ((Postpartum* or post-partum* or peripartum* or peri-partum*) next cardiomyopath*) 50
#14 (postcardiotomy or Post-cardiotomy) 48
#15 PPCM 41
#16 (myocard* next (stun* or hibernat* or infarct*)) 39538
#17 MeSH descriptor: [Primary Graft Dysfunction] this term only and with qualifier(s): [therapy - TH] 3
#18 (primary* next graft* next dysfunct*) 150
#19 #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 44787
#20 MeSH descriptor: [Cardiopulmonary Resuscitation] this term only and with qualifier(s): [methods - MT] 761
#21 MeSH descriptor: [Extracorporeal Membrane Oxygenation] this term only and with qualifier(s): [methods - MT] 103
#22 ECMO 1170
#23 MeSH descriptor: [Extracorporeal Circulation] this term only and with qualifier(s): [methods - MT] 123
#24 (extracorp* next circulat*) 1423
#25 (extracorp* next ((cardiopulmon* next resuscitat*) or CPR)) 80
#26 ECPR 127
#27 (Biomedicus next pump*) 2
#28 (Maquet* next rotaflow*) 2
#29 (jostra next (pump* or rotaflow*)) 0
#30 (levitronix next (centrimag* or pump* or system* or oxygen*)) 0
#31 (Medos next (Hilite* or oxygen*)) 0
#32 (left next ventricle next assist next device) 1
#33 #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 3455
#34 #19 AND #33 with Cochrane Library publication date Between Sep 2013 and Jun 2025, in Cochrane Reviews 30
#35 conference:pt or (clinicaltrials or trialsearch or clinicaltrials.gov or www.who.int) 861611
#36 #34 not #35 0
Cochrane Central (CDSR) search strategy
#1 MeSH descriptor: [Heart Failure] this term only and with qualifier(s): [therapy - TH] 2567
#2 MeSH descriptor: [Acute Disease] this term only and with qualifier(s): [therapy - TH] 115
#3 #1 and #2 0
#4 MeSH descriptor: [Cardiomyopathies] this term only and with qualifier(s): [therapy - TH] 86
#5 MeSH descriptor: [Shock, Cardiogenic] this term only and with qualifier(s): [therapy - TH] 194
#6 MeSH descriptor: [Myocardial Stunning] this term only and with qualifier(s): [therapy - TH] 3
#7 MeSH descriptor: [Myocarditis] this term only and with qualifier(s): [therapy - TH] 13
#8 MeSH descriptor: [Myocardial Infarction] this term only and with qualifier(s): [therapy - TH] 2729
#9 MeSH descriptor: [Out-of-Hospital Cardiac Arrest] this term only and with qualifier(s): [therapy - TH] 568
#10 ((acute* or severeor refract) next (heart* or cardiac* or myocard* or cardio* or ventric*) next (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock* or arrest* or stunn*)) 2872
#11 (cardiogen* next shock) 1767
#12 Myocardit* 1473
#13 ((Postpartum* or post-partum* or peripartum* or peri-partum*) next cardiomyopath*) 50
#14 (postcardiotomy or Post-cardiotomy) 48
#15 PPCM 41
#16 (myocard* next (stun* or hibernat* or infarct*)) 39538
#17 MeSH descriptor: [Primary Graft Dysfunction] this term only and with qualifier(s): [therapy - TH] 3
#18 (primary* next graft* next dysfunct*) 150
#19 #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 44787
#20 MeSH descriptor: [Cardiopulmonary Resuscitation] this term only and with qualifier(s): [methods - MT] 761
#21 MeSH descriptor: [Extracorporeal Membrane Oxygenation] this term only and with qualifier(s): [methods - MT] 103
#22 ECMO 1170 #23 MeSH descriptor: [Extracorporeal Circulation] this term only and with qualifier(s): [methods - MT] 123
#24 (extracorp* next circulat*) 1423
#25 (extracorp* next ((cardiopulmon* next resuscitat*) or CPR)) 80
#26 ECPR 127
#27 (Biomedicus next pump*) 2
#28 (Maquet* next rotaflow*) 2
#29 (jostra next (pump* or rotaflow*)) 0
#30 (levitronix next (centrimag* or pump* or system* or oxygen*)) 0
#31 (Medos next (Hilite* or oxygen*)) 0
#32 (left next ventricle next assist next device) 1
#33 #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 3455
#34 #19 AND #33 with Cochrane Library publication date Between Sep 2013 and Jun 2025, in Trials 499
#35 conference:pt or (clinicaltrials or trialsearch or clinicaltrials.gov or www.who.int) 861611 #36 #34 not #35 295
INHTA HTA Database search strategy
1 , "Heart Failure"[mh] , 271
2 , "Acute Disease"[mh] , 44
3 , #2 AND #1 , 2
4 , "Cardiomyopathies"[mh] , 25
5 , "Shock, Cardiogenic"[mh] , 11
6 , "Myocardial Stunning"[mh] , 1
7 , "Myocarditis"[mh] , 2
8 , "Myocardial Infarction"[mh] , 122
9 , "Out-of-Hospital Cardiac Arrest"[mh] , 11
10 , ((acute* or severe* or refract*) AND (heart* or cardiac* or myocard* or cardio* or ventric*) AND (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock* or arrest* or stunn*) , 268
11 , (cardiogen* AND shock) , 19
12 , Myocardit* , 5
13 , ((Postpartum* or post-partum* or peripartum* or peri-partum*) AND cardiomyopath*) , 1
14 , (postcardiotomy or Post-cardiotomy) , 0
15 , PPCM , 0
16 , (myocard* AND (stun* or hibernat* or infarct*)) , 236
17 , "Primary Graft Dysfunction"[mh] , 0
18 , (primary* AND graft* AND dysfunct*) , 3
19 , #18 OR #17 OR #16 OR #15 OR #14 OR #13 OR #12 OR #11 OR #10 OR #9 OR #8 OR #7 OR #6 OR #5 OR #4 OR #3 , 523
20 , "Cardiopulmonary Resuscitation"[mh] , 23
21 , "Extracorporeal Membrane Oxygenation"[mh] , 28
22 , ECMO , 30
23 , "Extracorporeal Circulation"[mh] , 8
24 , (extracorp* AND circulat*) , 13
25 , (extracorp* AND ((cardiopulmon* AND resuscitat*) or CPR)): , 8
26 , ECPR , 4
27 , (Biomedicus AND pump*) , 0
28 , (Maquet* AND rotaflow*) , 0
29 , (jostra AND (pump* or rotaflow*)) , 0
30 , (levitronix AND (centrimag* or pump* or system* or oxygen*)) , 0
31 , (Medos AND (Hilite* or oxygen*)) , 0
32 , (Left AND ventricle AND assist AND device) , 3
33 , #32 OR #31 OR #30 OR #29 OR #28 OR #27 OR #26 OR #25 OR #24 OR #23 OR #22 OR #21 OR #20 , 72
34 , #33 AND #19 , 29
Inclusion criteria
The following inclusion criteria were applied to the abstracts identified by the literature search.
Publication type: clinical studies were included with emphasis on identifying good quality studies. Abstracts were excluded if they did not report clinical outcomes. Reviews, editorials, and laboratory or animal studies, were also excluded and so were conference abstracts, because of the difficulty of appraising study methodology, unless they reported specific adverse events not available in the published literature.
Population: adults with postcardiotomy cardiogenic shock.
Intervention or test: VA ECMO.
Outcome: articles were retrieved if the abstract contained information relevant to the safety, efficacy, or both.
If selection criteria could not be determined from the abstracts the full paper was retrieved.
Potentially relevant studies not included in the main evidence summary are listed in Appendix B: Other relevant studies.
Find out more about how NICE selects the evidence for the committee.
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