التفاصيل البيبلوغرافية
| العنوان: |
Intra-Aortic Balloon Pump Effects on Macrocirculation and Microcirculation in Cardiogenic Shock Patients Supported by Venoarterial Extracorporeal Membrane Oxygenation. |
| المؤلفون: |
Petroni, Thibaut1, Harrois, Anatole2, Amour, Julien3, Lebreton, Guillaume4, Brechot, Nicolas1, Tanaka, Sébastien2, Luyt, Charles-Edouard1, Trouillet, Jean-Louis1, Chastre, Jean1, Leprince, Pascal4, Duranteau, Jacques2, Combes, Alain1 alain.combes@psl.aphp.fr |
| المصدر: |
Critical Care Medicine. Sept2014, Vol. 42 Issue 9, p2075-2082. 8p. |
| مصطلحات موضوعية: |
*INTRA-aortic balloon counterpulsation, *MICROCIRCULATION, *CARDIOGENIC shock, *EXTRACORPOREAL membrane oxygenation, *PULMONARY artery, *PATIENTS |
| مستخلص: |
Objectives: This study was designed to assess the effects on macrocirculation and microcirculation of adding an intra-aortic balloon pump to peripheral venoarterial extracorporeal membrane oxygenation in patients with severe cardiogenic shock and little/ no residual left ventricular ejection. Design: A prospective, single-center, observational study where macrocirculation and microcirculation were assessed with clinical-, Doppler echocardiography-, and pulmonary artery-derived hemodynamic variables and also cerebral and thenar eminence tissue oxygenation and side-stream dark-field imaging of sublingual microcirculation. Setting: A 26-bed tertiary ICU in a university hospital. Patients: We evaluated 12 consecutive patients before and 30 minutes after interrupting and restarting intra-aortic balloon pump. Interventions: Measurements were performed before, and 30 minutes after interrupting and restarting intra-aortic balloon pump. Measurements and Main Results: Stopping intra-aortic balloon pump was associated with higher pulmonary artery-occlusion pressure (19± 10 vs 15±8mm Hg, p = 0.01), increased left ventricular end-systolic (51 ± 13 vs 50±14mm, p = 0.05) and end-diastolic (55 ± 13 v s 52 ± 14mm ,p = 0.003) dimensions, and decreased pulse pressure (15± 13 vs 29±22mm Hg, p = 0.02). Maximum pulmonary artery-occlusion pressure reduction when the intra-aortic balloon pump was restarted was observed in the seven patients whose pulmonary artery-occlusion pressure was more than 15 mm Hg when intra-aortic balloon pump was off (-6.6 ± 4.3 vs -0.6±3.4mm Hg, respectively). Thenar eminence and brain tissue oxygenation and side-stream dark-field-assessed sublingual microcirculation were unchanged by stopping and restarting intra-aortic balloon pump. Conclusions: Restoring pulsatility and decreasing left ventricular afterload with intra-aortic balloon pump was associated with smaller left ventricular dimensions and lower pulmonary artery pressures but did not affect microcirculation variables in cardiogenic shock patients with little/no residual left ventricular ejection while on peripheral venoarterial extracorporeal membrane oxygenation. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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