Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used to treat refractory cardiogenic shock (CS) or cardiac arrest (CA) over the past decades. Peripheral VA-ECMO increases left ventricular (LV) afterload, potentially impairing myocardial recovery and leading to poor outcomes. Intra-aortic balloon pump (IABP) has been suggested as an approach to unload LV in patients supported by VA-ECMO [1]. However, the effectiveness of IABP combined with VA-ECMO remains controversial [2,3,4]. Using the data from the Chinese Extracorporeal Life Support (CSECLS) registry, we aimed to evaluate in-hospital outcomes in CS patients who received VA-ECMO with or without IABP.

The CSECLS registry is a voluntary database that collects information on ECMO use, complications, and outcomes in adults and children from more than 112 member centers in China. Data were collected using a standardized electronic reporting sheet submitted on the organization’s website. We included adults (≥ 18 years) who received femoro-femoral VA-ECMO with IABP (IABP group) or without IABP (non-IABP group) from January 1, 2017, through August 31, 2022. We excluded patients received central cannulation or other LV unloading strategies. The primary outcome was in-hospital mortality. Secondary outcomes included survival to ECMO weaning, continuous renal replacement therapy (CRRT), cannulation site bleeding, and limb ischemia. This study was approved by the Research Ethics Board of the Beijing Anzhen Hospital (2021020X).