Successful Use of Intraaortic Balloon Pumping in a 2-kilogram Infant

Acute left ventricular dysfunction in children justifies aggressive treatment because of the high potential for complete recovery. The options for providing mechanical support to the failing heart in a child include extracorporeal membrane oxygenation, left ventricular assist devices, and the use of the intra-aortic balloon pump (IABP). The IABP is a commonly used method of temporary circulatory support in adults. However, despite the availability of pediatric size balloons, the usage of IABP for temporary circulatory support in children has not been widespread. Current case report, first from India in pediatric age group, aims to aware the pediatric intensivist about the role of IABP in providing temporary mechanical cardiovascular support in managing patients with refractory low cardiac output state.

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“…reported the successful utilization of IABP support in a 2 kg infant with low cardiac output of unknown cause. [13]…”

Section: Discussionmentioning

confidence: 99%

Refractory pediatric cardiogenic shock: A case for mechanical support

Sachdev

Mehra

Mohanty

et al. 2016

Indian Journal of Critical Care Medicine

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“…Therapeutic options for the failing Fontan circuit include medical manipulations, such as the use of nitric oxide, cardiac pacing, devices to improve venous return, such as intermittent compression of the abdomen or lower body, revision of Fontan connection, conversion to a hemi-Fontan circulation, mechanical circulatory assistance, and finally, orthotopic cardiac transplantation. [1][2][3][4][5][6] Supraventricular arrhythmias, systemic ventricular dysfunction, structural problems, and collateral circulation are among the major causes of failure. Because of this heterogeneity, the options for management need to be individualized.…”

Section: Discussionmentioning

confidence: 99%

“…We discovered 21 instances of such treatment, albeit with almost two-thirds dying. [1][2][3][4][5] In this report, we describe successful use of intra-aortic balloon counterpulsation in an adult patient with a failing Fontan circulation.…”

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confidence: 99%

Intra-aortic balloon counterpulsation in a patient with the failing Fontan circulation

Chowdhury

Subramaniam

2006

CTY

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We report a 23-year-old patient undergoing functionally univentricular repair who developed cardiac failure due primarily to systemic ventricular dysfunction. The failing Fontan circulation was successfully re-established using intra-aortic balloon counterpulsation. Aortic counterpulsation facilitates recovery of systemic ventricular function, and appears to be a reasonable alternative in select instances of cardiac failure in patients with the Fontan circulation.

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“…Its use in children remains limited due to technical considerations related to small patient and blood vessel size which complicates insertion and renders the IABP less effective. Early concerns about whether effective counterpulsation was achievable in the highly elastic and distensible aorta of young children have proven unfounded [18]. …”

Section: Short-term Mcsmentioning

confidence: 99%

Mechanical Circulatory Support of the Critically Ill Child Awaiting Heart Transplantation

Gazit

Gandhi

Canter³

2010

CCR

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The majority of children awaiting heart transplantation require inotropic support, mechanical ventilation, and/or extracorporeal membrane oxygenation (ECMO) support. Unfortunately, due to the limited pool of organs, many of these children do not survive to transplant. Mechanical circulatory support of the failing heart in pediatrics is a new and rapidly developing field world-wide. It is utilized in children with acute congestive heart failure associated with congenital heart disease, cardiomyopathy, and myocarditis, both as a bridge to transplantation and as a bridge to myocardial recovery. The current arsenal of mechanical assist devices available for children is limited to ECMO, intra-aortic balloon counterpulsation, centrifugal pump ventricular assist devices, the DeBakey ventricular assist device Child; the Thoratec ventricular assist device; and the Berlin Heart. In the spring of 2004, five contracts were awarded by the National Heart, Lung and Blood Institute to support preclinical development for a range of pediatric ventricular assist devices and similar circulatory support systems. The support of early development efforts provided by this program is expected to yield several devices that will be ready for clinical trials within the next few years. Our work reviews the current international experience with mechanical circulatory support in children and summarizes our own experience since 2005 with the Berlin Heart, comparing the indications for use, length of support, and outcome between these modalities.

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Successful Use of Intraaortic Balloon Pumping in a 2-kilogram Infant

Cited by 34 publications

References 2 publications

Refractory pediatric cardiogenic shock: A case for mechanical support

Refractory pediatric cardiogenic shock: A case for mechanical support

Intra-aortic balloon counterpulsation in a patient with the failing Fontan circulation

Mechanical Circulatory Support of the Critically Ill Child Awaiting Heart Transplantation

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