Assessment of ECMO in Acute Myocardial Infarction Cardiogenic Shock

Who May Qualify: - Cardiogenic shock complicating acute myocardial infarction (STEMI or NSTEMI) - Revascularization by PCI for acute myocardial infarction has been performed or is planned in the following 60 minutes - Systolic blood pressure \<90 mmHg for \>30 min or catecholamine support required to maintain systolic blood pressure \>90 mmHg - Signs of pulmonary congestion - Signs of impaired organ perfusion with at least one of the following: Altered mental status OR cold, clammy skin and extremities OR oliguria with urine output \<30 ml/h OR serum lactate \>2.0 mmol/l Who Should NOT Join This Trial: - Age \<18 years - Pregnancy - Onset of shock \>24 Hours - Shock of other cause (hypovolemic, anaphylactic or vagal shock) - Shock due to massive pulmonary embolism - Resuscitation \>30 minutes - No intrinsic heart activity - Patient moribund on the day of randomization or SAPS II \>90 - Surgical revascularization for AMI (CABG) planned or already performed prior to randomization - Cerebral deficit with fixed dilated pupils or Irreversible neurological pathology - Mechanical infarction complication (massive mitral regurgitation, pericardium drainage required, septal ventricular defect) - Severe peripheral artery disease or previous aortic or ilio-femoral surgery precluding ECMO and IABP insertion - Aortic regurgitation \> II - Other severe concomitant disease with limited life expectancy \< 1 year - Proven heparin-induced thrombocytopenia - ECMO device not immediately available Always talk to your doctor about whether this trial is right for you.