{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:12:03Z","timestamp":1779351123347,"version":"3.51.4"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,12,6]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Mechanical circulatory support devices, such as the intra\u2010aortic balloon pump (IABP) and Impella, are often used in patients on veno\u2010arterial extracorporeal life support (VA\u2010ECLS) with cardiogenic shock despite limited supporting clinical trial data.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Hospitalizations for cardiogenic shock from 2016 to 2018 were identified from the National Inpatient Sample. Trends in the use of VA\u2010ECLS with and without an IABP or Impella were assessed semiannually. Multivariable logistic regression and general linear regression evaluated the association of Impella and IABP use with in\u2010hospital outcomes. Overall, 12\u2009035 hospitalizations with cardiogenic shock and VA\u2010ECLS were identified, of which 3115 (26%) also received an IABP and 1880 (16%) an Impella. Use of an Impella with VA\u2010ECLS substantially increased from 10% to 18% over this period (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), whereas an IABP modestly increased from 25% to 26% (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In\u2010hospital mortality decreased 54% to 48% for VA\u2010ECLS only, 61% to 58% for VA\u2010ECLS with an Impella, and 54% to 49% for VA\u2010ECLS with an IABP (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001 each). Most (57%) IABPs or Impellas were placed on the same day as VA\u2010ECLS. After adjustment, there were no differences in in\u2010hospital mortality or length of stay with the addition of an IABP or Impella compared with VA\u2010ECLS alone.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">From 2016 to 2018 in the United States, use of an Impella and IABP with VA\u2010ECLS significantly increased. More than half of Impellas and IABPs were placed on the same day as VA\u2010ECLS, and the use of a second mechanical circulatory support device did not impact in\u2010hospital mortality. Further studies are needed to decipher the optimal timing and patient selection for this growing practice.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.025216","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T11:05:16Z","timestamp":1669287916000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Trends in Veno\u2010Arterial Extracorporeal Life Support With and Without an Impella or Intra\u2010Aortic Balloon Pump for Cardiogenic Shock"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5350-3320","authenticated-orcid":false,"given":"Michael J.","family":"Hendrickson","sequence":"first","affiliation":[{"name":"Department of Medicine, Massachusetts General Hospital Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vardhmaan","family":"Jain","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Emory University School of Medicine Atlanta GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4785-0059","authenticated-orcid":false,"given":"Kirtipal","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Mount Sinai Heart Division of Advanced Heart Failure and Transplant Cardiology, Mount Sinai St. Lukes Hospital New York NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Chew","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Arora","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph S.","family":"Rossi","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-9637","authenticated-orcid":false,"given":"Pedro","family":"Villablanca","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology Henry Ford Hospital Detroit MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8302-6796","authenticated-orcid":false,"given":"Navin K.","family":"Kapur","sequence":"additional","affiliation":[{"name":"Division of Cardiology Tufts Medical Center Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditya A.","family":"Joshi","sequence":"additional","affiliation":[{"name":"Division of Advanced Heart Failure and Transplant Cardiology, Department of Cardiovascular Medicine University of Washington Seattle WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5476-6827","authenticated-orcid":false,"given":"Arieh","family":"Fox","sequence":"additional","affiliation":[{"name":"Zena and Michael A. Wiener Cardiovascular Institute Icahn School of Medicine at Mount Sinai New York NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1906-5958","authenticated-orcid":false,"given":"Kiran","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Zena and Michael A. Wiener Cardiovascular Institute Icahn School of Medicine at Mount Sinai New York NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7933-7794","authenticated-orcid":false,"given":"Edo Y.","family":"Birati","sequence":"additional","affiliation":[{"name":"Poriya Medical Center Bar\u2010Ilan University Tiberias Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J.","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology, NorthShore Cardiovascular Institute University of Chicago Pritzker School of Medicine Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0607-1240","authenticated-orcid":false,"given":"Arman","family":"Qamar","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology, NorthShore Cardiovascular Institute University of Chicago Pritzker School of Medicine Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000590"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv051"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60958-7"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036691"},{"key":"e_1_3_1_6_2","unstructured":"High mortality associated with intracardiac and intrapulmonary thromboses after cardiopulmonary bypass | SpringerLink. 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