Assisted Circulation in Cardiac and Respiratory Insufficiency

Abstract

Intra-aortic counterpulsation with a balloon pump (IABP) was used in 63 patients with cardiogenic shock, heart failure after surgery with artificial circulation, internal lacerations of the myocardium, or unstable angina. It was found that the IABP was most efficient in conditions related to myocardial ischemia. Use of arteriovenous perfusion (in 11 patients) or artificial ventricles is indicated in severe perturbations of the pumping function of the heart. As experience has shown, cardiologic and heart surgery patients usually have multiorgan insufficiency. For this reason, it is necessary to use other artificial organs in complex treatment: artificial lungs, kidneys, livers, etc.

Acute Beneficial Effects of Muscular Counterpulsation in Patients with Coronary Heart Diseases

“…The mechanism by which the IABPassisted circulation (AC) system improves hemodynamics is twofold: first, inflation of a balloon inserted into the body up to the arcus aortae at the onset of diastole results in the aortal lumen occlusion and proximal blood displacement, leading to augmented pressure and improved coronary flow (increased oxygen supply); second, balloon deflation in presystole results in an open aortal lumen and a decrease in pressure and left ventricular systolic off-loading (decreased oxygen demand). 7,8 Despite the beneficial properties of the IABP, it appears that up to 20% of vascular complications that occur (limb ischemia and embolization) are mainly related to the invasive nature of the device. 9,10 This risk of severe complications has limited the indications of this therapy only to critical patients with severe hemodynamic compromise 11 and performance in a surgical theater or intensive care unit.…”