Intra‐aortic balloon pump impacts the regional haemodynamics of patients with cardiogenic shock treated with femoro‐femoral veno‐arterial extracorporeal membrane oxygenation

Autor: Bo Xu, Chenglong Li, Tong Cai, Yongchao Cui, Zhongtao Du, Qiushi Fan, Dong Guo, Chunjing Jiang, Zhichen Xing, Meng Xin, Pengcheng Wang, Liangshan Wang, Feng Yang, Ming Jia, Hong Wang, Xiaotong Hou
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: ESC Heart Failure, Vol 9, Iss 4, Pp 2610-2617 (2022)
Druh dokumentu: article
ISSN: 2055-5822
14839946
DOI: 10.1002/ehf2.13981
Popis: Abstract Aims To investigate the impact of intra‐aortic balloon pump (IABP) on the regional haemodynamics of patients with severe cardiogenic shock undergoing femoro‐femoral veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO). Methods and results From July 2017 to April 2018, a total of 39 adult patients with cardiogenic shock receiving both IABP and ECMO for circulatory support were enrolled consecutively in a university‐affiliated cardiac surgery intensive care unit. The blood flow rates (BFRs) of the bilateral femoral artery (IABP side: iFA, ECMO side: eFA) and carotid artery (left: LCA, right: RCA) and the velocity time integral (VTI) of aortic root were assessed by ultrasonography and compared when IABP was on and off. Seventeen of 39 (43.6%) patients survived to discharge, and 29 (74.4%) survived on ECMO. A total of 172 pairs of data (IABP on and off) were collected in this study, measured on the median of 2.0 (1.0, 4.5) days after patients received VA‐ECMO. The BFR on both sides of FA (iFA: 176.4 ± 104.5 vs. 152.2 ± 139.8 mL/min, P 3.5 L/min). Conclusions Concomitant IABP used in patients undergoing femoro‐femoral VA‐ECMO was associated with increased aortic VTI and BFR in bilateral FA. The change in CA BFR depended on cardiac function. A decreased LCA BFR was observed in patients with cardiac stunning when IABP was turned on, which might be compensated by a higher ECMO blood flow. Further study is needed to confirm the relationship between BFR and extremities and neurological complications.
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