Abstract Rationale The use of short-term mechanical circulatory support (MCS) devices, including intra-aortic balloon pump (IABP) or Impella devices, is increasing among patients treated in cardiac intensive care units (CICUs). These individuals are often at high risk for in-hospital cardiac arrest (IHCA). However, there are limited data describing IHCA outcomes in these individuals. This study compared IHCA outcomes between CICU patients who had short-term MCS during their arrest and those who did not. We hypothesized that patients with MCS at the time of arrest (compared to patients without MCS) would be less likely to achieve return of spontaneous circulation (ROSC), survive to discharge, and have worse neurological outcomes. Methods This was a single-center, retrospective cohort study that examined index IHCA in adult ICU patients on a primary cardiology service from 2025 to 2015. The exposure group was defined as receiving any of the following MCS during their arrest: IABP and/or Impella (5.5, CP or RP). Patients on ECMO and durable MCS were excluded. Outcomes of interest were favorable cerebral performance score (CPC) of 1 or 2 at 30 days or discharge, survival to discharge, and ROSC. Multivariable logistic regression models, adjusting for age, sex, and Charlson Comorbidity Index (CCI) group, were conducted to examine the association between short-term MCS exposure during an index arrest and favorable CPC score, survival to discharge, and ROSC. Results A total of 115 patients were included (30 with MCS and 85 without). Groups were similar age, sex, or body mass index (BMI), CCI, arrest rhythm, presence of an implantable cardiac defibrillator (ICD) or need for extracorporeal membrane oxygenation (ECMO) during admission. The MCS group had higher rates of prior heart attack (46.7% vs 20%, P = 0.005) and prior cardiac arrest (33.3% vs 14.1%, P = 0.021). After adjusting for age, sex, and CCI, there was no statistically significant difference between groups with respect to favorable CPC score (adj OR 1.31, 95% CI 0.51-3.29, P = 0.57), survival to discharge (adj OR 0.73, 95% CI 0.27-1.83, P = 0.51), or ROSC (adj OR 1.13, 95% CI 0.40-3.50, P = 0.83). Conclusions Patients with short-term MCS are a high-risk and growing population. These data suggest that the presence of short-term MCS during IHCA is not associated with worse outcomes. There is prior literature in animal models suggesting a protective effect of MCS during cardiac arrest. However, larger studies are needed to explore this potential protective effect further. This abstract is funded by: None
Sisk et al. (2026) studied this question.