A Study on the Effects of Left Ventricular Unloading in the Setting of VA ECMO Support

Inclusion criteria for the registry backbone: * Having received ECMO support for severe circulatory and/or respiratory insufficiency Inclusion Criteria for the LV unloading trial domain (VA ECMO + IABP vs VA ECMO alone): * Cardiogenic shock * Having received VA ECMO support for severe circulatory (and respiratory insufficiency). * Age ≥ 18 years * Initiation of LV unloading (IABP or Impella) possible ≤ 8 hours after ECMO initiation Exclusion criteria for the registry backbone * Objection to participation in the registry by the patient and/or proxy * VA ECMO usage confined to the period during surgery or another intervention (the VA ECMO was removed at the end of the intervention in the operation room). Exclusion criteria for the LV unloading trial domain (VA ECMO + IABP vs VA ECMO alone) * No (deferred) informed consent provided by the patient and/or proxy. * Pregnancy * ECMO usage confined to the period during surgery or another intervention (the ECMO was removed at the end of the intervention). * Isolated right ventricular failure (e.g. due to pulmonary embolism). * Left ventricular assist device (LVAD), Impella or IABP in situ. * Ventricular septal defect or papillary muscle rupture as the cause of shock. * Thoracic or abdominal aortic dissection. * Moderate or severe aortic regurgitation * Mechanical prosthesis in mitral valve position