Intra-aortic balloon pump after VA-ECMO reduces mortality in patients with cardiogenic shock: an analysis of the Chinese extracorporeal life support registry

Wang, K; Wang, L; Ma, J; Xie, H; Li, C; Hao, X; Du, Z; Wang, H; Hou, X

doi:10.1186/s13054-024-05129-1

Organ support & nutrition

Intra-aortic balloon pump after venoarterial extracorporeal membrane oxygenation (VA-ECMO) reduces mortality in patients with cardiogenic shock: an analysis of the Chinese extracorporeal life support registry

Crit CarePublished 29 Nov 2024Retrospective cohort study

Main finding · In-hospital mortalityResultAdjusted odds ratio 0.823 95% CI 0.686–0.987

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Authors' conclusion

In this multicenter retrospective study, the use of IABP after VA-ECMO was associated with lower in-hospital mortality in patients with CS.

Study context

Population: Consecutive patients with cardiogenic shock treated with VA-ECMO, Chinese extracorporeal life support (CSECLS) registry, January 2017–July 2023
Participants: 5,492 patients

Exposure: Intra-aortic balloon pump (IABP) after VA-ECMO vs no IABP after VA-ECMO
IABP after VA-ECMOn = 832
Outcome: In-hospital mortality

Methodological detailsmulticenter, registry (CSECLS), multivariate modeling

Multicenter
Registry (CSECLS)
Multivariate modeling

Main finding

As reported in the abstract

Adjusted odds ratio

0.823

95% CI 0.686–0.987

P = 0.035

By group

No IABP52.5%

IABP after VA-ECMO48.0%

IABP after VA-ECMO vs No IABP

aOR 0.823 (95% CI 0.686–0.987); P = 0.035

Observational data: associations, not effects.

Secondary outcomes

Survival on VA-ECMO

P = 0.014

IABP after VA-ECMO79.4%

No IABP75.4%

Outcome	← Lower odds with IABP after VA-ECMO ←→ Higher odds with IABP after VA-ECMO →	aOR (95% CI)	P value
On-support mortality	0.512	0.828 (0.688–0.995)	P = 0.044
	0.512Adjusted odds ratio (log scale)

Safety

Outcome	← Lower odds with IABP after VA-ECMO ←→ Higher odds with IABP after VA-ECMO →	aOR (95% CI)	P value
Mechanical complications	0.20.5125	1.905 (1.278–2.839)	P = 0.002
Bleeding complications	0.20.5125	1.371 (1.092–1.721)	P = 0.007
Renal complications	0.20.5125	1.252 (1.041–1.505)	P = 0.017
Pulmonary complications	0.20.5125	1.768 (1.446–2.163)	P < 0.001
	0.20.5125Adjusted odds ratio (log scale)

Original publication

Intra-aortic balloon pump after VA-ECMO reduces mortality in patients with cardiogenic shock: an analysis of the Chinese extracorporeal life support registry. Crit Care. Published 29 November 2024. doi:10.1186/s13054-024-05129-1

Read the original article ↗

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