High-dose insulin (HDI) therapy has been used as inotropic support for toxin-induced cardiogenic shock with great success,[1] but literature suggests that its inotropic effects can be used in non-toxin-induced cardiogenic shock states as well, especially when a dose of at least 1 U/kg/hr is used.[2,3] This is an Atrium institutional review board-approved case report of a patient with acute nonischemic biventricular failure who was supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and was transitioned off ECMO support using HDI therapy. Here, INS is linked to Shock.