Background Mechanical circulatory support devices, such as the intra‐aortic balloon pump (IABP) and Impella, are often used in patients on veno‐arterial extracorporeal life support (VA‐ECLS) with cardiogenic shock despite limited supporting clinical trial data. Methods and Results Hospitalizations for cardiogenic shock from 2016 to 2018 were identified from the National Inpatient Sample. Trends in the use of VA‐ECLS with and without an IABP or Impella were assessed semiannually. Multivariable logistic regression and general linear regression evaluated the association of Impella and IABP use with in‐hospital outcomes. Overall, 12 035 hospitalizations with cardiogenic shock and VA‐ECLS were identified, of which 3115 (26%) also received an IABP and 1880 (16%) an Impella. Use of an Impella with VA‐ECLS substantially increased from 10% to 18% over this period (P
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