Arterial impedance in patients furing intraaortic balloon counterpulsation

Kim, Shin Y.; Euler, David E.; Jacobs, William R.; Montoya, Alvaro; Sullivan, Henry J.; Lonchyna, Vassyl A.; Pifarré, Roque

doi:10.1016/0003-4975(95)01168-4

Cited by 17 publications

(20 citation statements)

References 19 publications

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“…These characteristics have not been associated with a decrease in left ventricular work(16,17). In chronic heart failure, IABP reduces arterial impedance(18) and the resultant increase in stroke volume may be enough to rescue patients from severe shock. As an example, Rosenbaum et.…”

Section: Discussionmentioning

confidence: 99%

Intra-Aortic Balloon Counterpulsation in Patients With Chronic Heart Failure and Cardiogenic Shock: Clinical Response and Predictors of Stabilization

Sintek

Gdowski

Lindman

et al. 2015

Journal of Cardiac Failure

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Objective To characterize the clinical response and identify predictors of clinical stabilization after intra-aortic balloon counterpulsation (IABP) support in patients with chronic systolic heart failure in cardiogenic shock prior to implantation of a left ventricular assist device (LVAD). Background Limited data exist regarding the clinical response to IABP in patients with chronic heart failure in cardiogenic shock. Methods We identified 54 patients supported with IABP prior to LVAD implantation. Criteria for clinical decompensation after IABP insertion and before LVAD included the need for more advanced temporary support, initiation of mechanical ventilation or dialysis, increase in vasopressors/inotropes, refractory ventricular arrhythmias, or worsening acidosis. The absence of these indicated stabilization. Results Clinical decompensation after IABP occurred in 23 (43%) patients. Both patients who decompensated and those who stabilized had similar hemodynamic improvements after IABP support but patients who decompensated required more vasopressors/inotropes. Clinical decompensation after IABP was associated with worse outcomes after LVAD implantation, including a 3-fold longer intensive care unit stay and 5-fold longer time on mechanical ventilation (p<0.01 for both). While baseline characteristics were similar between groups, right and left ventricular cardiac power indices (Cardiac power Index= Cardiac Index × Mean arterial pressure / 451)identified patients who were likely to stabilize (AUC=0.82). Conclusions Among patients with chronic systolic heart failure who develop cardiogenic shock, more than half of patients stabilized with IABP support as a bridge to LVAD. Baseline measures of right and left ventricular cardiac power, both measures of work performed for a given flow and pressure, may allow clinicians to identify patients with sufficient contractile reserve who will be likely to stabilize with an IABP versus those who may need more aggressive ventricular support.

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Section: Discussionmentioning

confidence: 99%

Intra-Aortic Balloon Counterpulsation in Patients With Chronic Heart Failure and Cardiogenic Shock: Clinical Response and Predictors of Stabilization

Sintek

Gdowski

Lindman

et al. 2015

Journal of Cardiac Failure

View full text Add to dashboard Cite

show abstract

“…The intra‐aortic balloon pump (IABP) is the mechanical circulatory assistance device most frequently used for haemodynamic support (Kim et al. 1996, Stefanadis et al.…”

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confidence: 99%

“…Different IABP assistance modalities determine dissimilar vascular pressure and flow changes that could be associated with different effects on the local (aortic) and global (whole systemic circulation) biomechanical behaviour. However, the few works that assessed the vascular properties during IABP assistance did not allow discriminating the differential effects of augmented and assisted beats, differ in the control group and/or did not characterize the similarities/differences of augmented beats during different IABP modalities (Kim et al. 1996, Stefanadis et al.…”

mentioning

confidence: 99%

“…The IABP assistance is used in clinical situations that differ in the vascular functional capability (Kim et al. 1996, Stefanadis et al.…”

mentioning

confidence: 99%

“…However, up to now, the studies of IABP effects on the aortic properties were performed in patients whose arterial reactivity (i.e. VSM and/or endothelium response) and/or pressure‐dependent properties were expected to be altered (although they were not analysed) (Kim et al. 1996, Stefanadis et al.…”

mentioning

confidence: 99%

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