Concomitant intra-aortic balloon pump and veno-arterial extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock.
Amr A ArafatAbdulmalik A AlmedimighKhaled D AlgarniHuda H IsmailClaudio PragliolaAdam I AdamMohammed AlBarrakAhmed OsmanMonirah A AlbabtainTarek M TantwayPublished in: The International journal of artificial organs (2023)
We aimed to compare the outcomes of ECMO with and without IABP for postcardiotomy cardiogenic shock. The study included 103 patients who needed ECMO for postcardiotomy cardiogenic shock. Patients were grouped according to the use of IABP into ECMO without IABP ( n = 43) and ECMO with IABP ( n = 60). The study endpoints were hospital complications, successful weaning, and survival. Patients with IABP had lower preoperative ejection fraction ( p = 0.002). There was no difference in stroke ( p = 0.97), limb ischemic ( p = 0.32), and duration of ICU stay ( p = 0.11) between groups. Successful weaning was non-significantly higher with IABP (36 (60%) vs 19 (44.19%); p = 0.11). Predictors of successful weaning were inversely related to the high pre-ECMO lactate levels (OR: 0.89; p = 0.01), active endocarditis (OR: 0.06; p = 0.02), older age (OR: 0.95; p = 0.02), and aortic valve replacement (OR: 0.26; p = 0.04). There was no difference in survival between groups ( p = 0.80). Our study did not support the routine use of IABP during ECMO support.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- mechanical ventilation
- ejection fraction
- respiratory failure
- aortic stenosis
- aortic valve replacement
- aortic valve
- intensive care unit
- metabolic syndrome
- patients undergoing
- prognostic factors
- physical activity
- transcatheter aortic valve implantation
- left ventricular
- patient reported outcomes
- atrial fibrillation
- skeletal muscle
- adipose tissue
- transcatheter aortic valve replacement
- pulmonary artery
- insulin resistance
- drug induced
- middle aged