We read with great interest the manuscript of de Waha et al1. The authors have to be congratulated for performing clinical research in this very challenging subset of patients.
In a series of 83 (consecutive?) patients with refractory cardiogenic shock (CS) undergoing extracorporeal life support (ECLS), they describe an in-hospital mortality of 68.7%, while at 18 months the survival was 18.1%. While the poor prognosis of patients with refractory CS is undeniable, a few points deserve consideration to put these results into perspective. First, the limited number of patients and the variety of underlying pathologies may have masked subgroups which may have ...
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