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Observational studies indicate that ECMELLA may reduce mortality but exposing the patient to two advanced mechanical support devices may affect the early inflammatory response. We aimed to explore inflammatory biomarkers in a porcine cardiogenic shock model managed with V-A ECMO or ECMELLA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Fourteen landrace pigs had acute myocardial infarction-induced cardiogenic shock with minimal arterial pulsatility by microsphere embolization and were afterwards managed 1:1 with either V-A ECMO or ECMELLA for 4 h. Serial blood samples were drawn hourly and analyzed for serum concentrations of interleukin 6 (IL-6), IL-8, tumor necrosis factor alpha, and serum amyloid A (SAA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>An increase in IL-6, IL-8, and SAA levels was observed during the experiment for both groups. At 2\u20134\u00a0h of support, IL-6 levels were higher in ECMELLA compared to V-A ECMO animals (difference: 1416\u00a0pg\/ml, 1278\u00a0pg\/ml, and 1030\u00a0pg\/ml). SAA levels were higher in ECMELLA animals after 3 and 4 h of support (difference: 401\u00a0ng\/ml and 524\u00a0ng\/ml) and a significant treatment-by-time effect of ECMELLA on SAA was identified (<jats:italic>p<\/jats:italic>\u2009=\u20090.04). No statistical significant between-group differences were observed in carotid artery blood flow, urine output, and lactate levels.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Left ventricular unloading with Impella during V-A ECMO resulted in a more extensive inflammatory reaction despite similar end-organ perfusion.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40635-024-00625-8","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T09:02:34Z","timestamp":1713776554000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Immediate inflammatory response to mechanical circulatory support in a porcine model of severe cardiogenic shock"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1775-9457","authenticated-orcid":false,"given":"Emilie","family":"Gregers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter H.","family":"Frederiksen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanna L. 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