Study limitations
This study was limited by its small sample size (Impella® group n = 7). Patients with Impella® might have been clinically and hemodynamically more stable, also underlined by significantly longer survival and lower mortality. Hence, clinical parameters like the need for blood transfusions and ECMO weaning are challenging to interpret in the ECMO+Impella® group. Also, hemodynamic parameters from bedside echocardiography are not captured in this analysis, and thus we cannot analyze differences in LV-distension parameters objectively between groups.