Global research trends and hotspots in extracorporeal membrane oxygenation for cardiogenic shock: a bibliometric review and knowledge mapping approach (1990–2024)

Background: Extracorporeal membrane oxygenation (ECMO) has emerged as a promising rescue strategy for patients with refractory cardiogenic shock (CS). However, comprehensive and quantitative insights into the global research landscape of ECMO in CS remain limited. This study aimed to address this gap by systematically mapping the global research landscape of ECMO in CS through bibliometric analysis and knowledge visualization. Methods: A narrative synthesis was used to provide concise summaries of the key findings, highlighting emerging research frontiers and thematic shifts over time. Publications related to ECMO management in CS from 1990 to 2024 were retrieved from the Web of Science Core Collection. CiteSpace and VOSviewer were used to analyze publication patterns, co-authorship networks, keyword clustering, and citation metrics. High-impact authors, institutions, countries, and emerging research frontiers were identified. Results: A total of 701 publications involving 4,433 authors from 1,105 institutions across 55 countries were analyzed. The United States led in both publication volume and citations, followed by Germany and China. Four major thematic clusters were identified: postcardiotomy shock, cardiac arrest, extracorporeal cardiopulmonary resuscitation (ECPR), acute myocardial infarction (AMI)-related mechanical circulatory support, and ECMO bridging to transplantation. Over time, research emphasis has shifted from general survival and mortality to protocol-driven care, predictive modeling, and long-term outcomes. Conclusions: ECMO for CS is a rapidly expanding field, with bibliometric patterns suggesting increasing research consolidation and thematic diversification. Bibliometric analysis revealed a centralized and collaborative academic ecosystem with evolving themes suggestive of a shift toward precision support, multidisciplinary management, and clinical guideline development. These insights provide a roadmap for future research and health policy planning.