Objective:To investigate the clinical value and prognostic factors of arteriovenous extracorporeal membrane oxygenation(VA-ECMO)support for the treatment of patients with refractory cardiogenic shock.Methods:We retrospectively analyzed the clinical data of 94 patients who underwent VA-ECMO assisted treatment for refractory cardiogenic shock from January 2022 to April 2023,analyzed the changes of echocardiographic pa-rameters of the patients before and after VA-ECMO assisted treatment,and classified them into the success group(73 cases)and the failure group(21 cases)according to the success of the withdrawal of VA-ECMO,and com-pared the general data,hemodynamic and biochemical parameters of the patients in the two groups,and analyze the independent risk factors affecting the clinical outcomes of patients.Results:①There were significant differ-ences in left ventricular stroke volume(LVSV),left ventricular ejection fraction(LVEF),mitral annulus systolic velocity(Sa),aortic valve orifice forward flow velocity(AV)and velocity-time integral(VTI)among different etio-logical groups(all P＜0.05).Compared with the acute myocardial ischemia(AMI)group,the LVSV,LVEF,and VTI measurements were lower in the fulminant myocarditis(FM)group and the primary cardiogenic shock(CS)group(all P＜0.05).②Among the 94 patients,73 patients were weaned successfully and 21 patients failed.The time of ECMO assistance in the success group was significantly shorter than that in the failure group(P＜0.05).③Compared with before ECMO,heart rate(HR),LVESV,E/e',hemoglobin(HGB),platelets(PLT),and glu-tamate aminotransferase(ALT),LVSV,LVEF,tricuspid annulus peak systolic velocity(S'),Sa,AV,VTI,TAPSE,and C-reactive protein(CRP)and white blood cells(WBC)were significantly different between successful group and failed group(all P＜0.05).Compared with the failure group,there were significant differences in lac-tate(Lac),WBC,Urea/Crea,shock index(SI),D-dimer,CRP,aspartate aminotransferase(AST),ALT and PLT before and after ECMO in the success group(all P＜0.05).④Multivariate logistic regression analysis showed that S',Lac,AST,ALT and Urea/Crea were the influencing factors of weaning success in patients with refractory cardiogenic shock.Conclusion:VA-ECMO treatment can significantly improve cardiac function in pa-tients with refractory cardiogenic shock.The dynamic evaluations of S',Lac,AST,ALT and Urea/Crea have certain value for the prognosis of patients.
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