Abstract: Objective: To explore the effect of ABC-based volume management on early volume overload in heart failure patients with Venous-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO), and provide a reference for volume management in VA-ECMO patients. Methods: A retrospective study was conducted on heart failure patients who received VA-ECMO treatment in the Coronary Care Unit of a tertiary grade A hospital in Tianjin from March 2019 to March 2024. Nineteen patients with conventional volume management from March 2019 to November 2021 were selected as the control group, and nineteen patients with ABC volume management from December 2021 to March 2024 were selected as the observation group. The effects of volume management within 3 days on patients with VA-ECMO treatment were compared between the two groups. Results: The mean arterial pressure and central venous pressure in the observation group were lower than those in the control group (P<0.05). There was no significant difference in the cumulative liquid balance between the two groups (P>0.05). There was a greater increase in left ventricular ejection fraction (P=0.020) and a greater decrease in brain natriuretic peptide (P=0.002) in the observation group. There was no statistically significant difference in creatinine levels between the two groups (P>0.05), while there was a significant decrease in creatinine level on the third day compared to those on the second day in the observation group (P=0.033). Conclusion: The application of ABC-based volume management is benefit to reduce the early volume load in patients with VA-ECMO, effectively improve the cardiac function, accelerate the recovery of renal function, and reduce the risk of pulmonary edema and acute kidney injury.

Key words: volume management; Activity Based Classification; VA-ECMO; early volume overload; heart failure