Einfluss von ECMO und IABP auf die Koronardurchblutung

Staudinger, Thomas; Vollroth, Marcel; Höbartner, M; Sauer, M.; Mende, M.; Mohr, Friedrich W.; Misfeld, Martín

doi:10.1007/s00063-014-0408-6

Cited by 6 publications

(3 citation statements)

References 22 publications

(24 reference statements)

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“…Next to this, the authors showed that independent of central or peripheral ECMO cannulation settings, adjunctive IABP improved the myocardial oxygen supply-demand balance. Schroeter and colleagues provided an experimental study investigating the impact of additional IABP during peripheral and central ECMO circulation on mean coronary arterial pressure (left anterior descending artery) [17]. The study protocol was performed repetitively for 2 min in several settings (100% ECMO flow vs. 50% ECMO flow).…”

Section: Haemodynamic Effects Of Simultaneous Iabp Support During Ecm...mentioning

confidence: 99%

“…Peripheral ECMO canulation leads to a significant decrease in mean coronary arterial pressure with higher myocardial oxygen demand. Moreover, retrograde ECMO circulation without IABP leads to significantly in-creased pressure in the coronary arteries in to antegrade ECMO circulation [17]. The mentioned experimental setting described short-term changes at the beginning of circulatory support.…”

Section: Haemodynamic Effects Of Simultaneous Iabp Support During Ecm...mentioning

confidence: 99%

“…Next to the option to implement ECMO therapy peripherally via femoral vessels or central via atrio-aortal cannulation, the influence of antegrade (central cannulation) or retrograde (in peripheral cannulation) flow on haemodynamic and organ perfusion during central (antegrade) or peripheral (retrograde) ECMO support is of clinical interest [16]. Schroeter et al demonstrated in an experimental protocol that antegrade ECMO perfusion with simultaneous IABP is useful, while concomitant IABP impairs perfusion of the coronary arteries in retrograde ECMO circulation [17].…”

Section: Introductionmentioning

confidence: 99%

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Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model

Djordjevic

Liakopoulos

Elskamp

et al. 2022

Life

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(1) Introduction: Simultaneous ECMO and IABP therapy is frequently used. Haemodynamic changes responsible for the success of the concomitant mechanical circulatory support system approach are rarely investigated. In a large-animal model, we analysed haemodynamic parameters before and during ECMO therapy, comparing central and peripheral ECMO circulation with and without simultaneous IABP support. (2) Methods: Thirty-three female pigs were divided into five groups: (1) SHAM, (2) (peripheral)ECMO(–)IABP, (3) (p)ECMO(+)IABP, (4) (central)ECMO(–)IABP, and (5) (c)ECMO(+)IABP. Pigs were cannulated in accordance with the group and supported with ECMO (±IABP) for 10 h. Systemic haemodynamics, cardiac index (CI), and coronary and carotid artery blood flow were determined before, directly after, and at five and ten hours on extracorporeal support. Systemic inflammation (IL-6; IL-10; TNFα; IFNγ), immune response (NETs; cf-DNA), and endothelial injury (ET-1) were also measured. (3) Results: IABP support during antegrade ECMO circulation led to a significant reduction of left ventricular pressure in comparison to retrograde flow in (p)ECMO(–)IABP and (p)ECMO(+)IABP. Blood flow in the left anterior coronary and carotid artery was not affected by extracorporeal circulation. (4) Conclusions: Concomitant central ECMO and IABP therapy leads to significant reduction of intracavitary cardiac pressure, reduces cardiac work, and might therefore contribute to improved recovery in ECMO patients.

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Section: Haemodynamic Effects Of Simultaneous Iabp Support During Ecm...mentioning

confidence: 99%

Section: Haemodynamic Effects Of Simultaneous Iabp Support During Ecm...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model

Djordjevic

Liakopoulos

Elskamp

et al. 2022

Life

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Pitfalls of cannulation for extracorporeal life support: review of the literature and illustrative case presentation

Geyer

Gohrbandt²,

Sagoschen

et al. 2017

J Artif Organs

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Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) are an increasingly established advanced therapy for emerging severe lung and/or cardiocirculatory dysfunction or failure. Several reports have provided evidence for a potential benefit in prognosis by ECLS in cases of cardiogenic shock including cardiopulmonary resuscitation. Routine use in specialized centers reduces the incidence of negative side effects (e.g., vascular/ischemic, embolic, hemorrhagic, hemolytic and, furthermore, septic). Vascular complications like not only limb ischemia but also hypoxia proximal to the cannulation site up to complete sectorial hypoxia called "harlequin phenomenon" could refer to be a major adverse event in ECLS which, therefore, should be limited primarily to cardiocirculatory indications. Here we report on a case with "harlequin phenomenon" after ECLS implementation as a relevant complication of the mode of cannulation and review benefits and risks of commonly used variants of vascular access.

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Venoarterial extracorporeal membrane oxygenation after coronary artery bypass grafting: Results of a multicenter study

Biancari

Dalén

Perrotti

et al. 2017

International Journal of Cardiology

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Einfluss von ECMO und IABP auf die Koronardurchblutung

Abstract: In antegrade perfusion the simultaneous use of IABP and ECMO is useful. In retrograde perfusion IABP impairs the mean arterial pressure and consequently the perfusion of the coronary arteries.

Cited by 6 publications

References 22 publications

Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model

Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model

Pitfalls of cannulation for extracorporeal life support: review of the literature and illustrative case presentation

Venoarterial extracorporeal membrane oxygenation after coronary artery bypass grafting: Results of a multicenter study

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