Veno-Arterial Extracorporeal Life Support (VA ECMO) is a critical intervention for patients with cardiogenic shock, serving as bridge to recovery, transplantation, or long-term therapies. The complexity of VA ECMO and its associated risks underscore the need for reliable prognostic markers to guide patient management. This study aimed to evaluate whether cholesterol levels could serve as a specific marker for ICU survival in patients with cardiogenic shock treated with VA ECMO.

A retrospective observational study was conducted at Catharina Hospital Eindhoven, The Netherlands, between January 2013 and November 2019. Data from 67 patients treated with VA ECMO were analyzed. Cholesterol levels were measured daily from day 1 to day 5 after VA ECMO initiation. Demographic data, comorbidities, and outcomes were extracted from the patient data management system. Statistical analysis was performed, with a focus on non-normality of data distribution and the predictive value of cholesterol levels on ICU survival.

The study identified a significant association between higher cholesterol levels on the first day of VA ECMO treatment and increased ICU survival. A cholesterol threshold of 2.0 mmol/L was found to be an independent predictor of survival, with patients above this threshold having a higher survival rate. Multivariate logistic regression analysis confirmed the significance of this cholesterol threshold in predicting ICU survival.

Cholesterol levels measured on the first day after the initiation of VA ECMO are a significant indicator of ICU survival in patients with cardiogenic shock. A threshold of 2.0 mmol/L is particularly predictive, offering a potential prognostic tool for clinicians managing these critically ill patients.