Combining ECMO with IABP for the Treatment of Critically Ill Adult Heart Failure Patients

Ma, Pengyu; Zhang, Zaiwang; Song, Tieying; Yang, Yunliang; Meng, Ge; Zhao, Jing; Wang, Chunping; Gu, Ke; Peng, Jingyan; Jiang, Bo; Qi, Yan; Yan, Ruyu; Ma, Xiaojing

doi:10.1016/j.hlc.2013.10.081

Cited by 72 publications

(64 citation statements)

References 13 publications

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“…In the contrast, Belohlavek and colleagues used a pig model of cardiac arrest and concluded that addition of IABP to femoro‐femoral ECMO may worsen coronary perfusion . In clinical practice, Ma and colleagues described improvements in several hemodynamic parameters in 54 cardiogenic shock patients supported with V‐A ECMO and IABP, and demonstrated that the combined therapy could improve treatment outcomes, but the study did not have a control group. However, the results from SHOCK II trial suggested that IABP did not reduce 30‐days mortality in patients with cardiogenic shock .…”

Section: Discussionmentioning

confidence: 99%

Short‐term outcomes of intra‐aortic balloon pump combined with venoarterial extracorporeal membrane oxygenation: A systematic review and meta‐analysis

Wang

Xing

2019

Artificial Organs

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The effectiveness of intra‐aortic balloon pump (IABP) combined with venoarterial extracorporeal membrane oxygenation (VA‐ECMO) in patients with cardiogenic shock or cardiac arrest remains controversial. The aim of this systematic review and meta‐analysis was to investigate the short‐term clinical outcomes of IABP combined with VA‐ECMO versus VA‐ECMO alone. We searched PubMed, Embase, and the Cochrane Library for English language articles published from inception to August 18, 2018. Observational studies comparing IABP combined with VA‐ECMO with VA‐ECMO were considered eligible for the current study. Twelve observational studies with 3704 patients were included. In the IABP combined with VA‐ECMO group mortality was 59.7%, compared with 65.8% in the VA‐ECMO alone group. The risk ratio (RR) for this comparison was 0.90 (95% confidence interval [CI], 0.80–1.02; P = 0.107; 59.7% vs. 65.8%). In the one‐way sensitivity analysis for estimating the effect of each study on mortality, omission of each study did not make a significant difference. Furthermore, the proportion of patients weaned from VA‐ECMO was significantly higher in IABP combined VA‐ECMO group than in the VA‐ECMO alone group (RR, 1.28; 95% CI, 1.21–1.35; P < 0.001; 77.9% vs. 61.2%). IABP combined with VA‐ECMO could improve success rate of weaning from VA‐ECMO, but did not reduce in‐hospital mortality in patients with cardiogenic shock or cardiac arrest.

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Section: Discussionmentioning

confidence: 99%

Short‐term outcomes of intra‐aortic balloon pump combined with venoarterial extracorporeal membrane oxygenation: A systematic review and meta‐analysis

Wang

Xing

2019

Artificial Organs

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“…The balloon deflates during systole, decreasing the afterload and increasing perfusion to the renal arteries supplying the kidneys, mesenteric arteries supplying the digestive organs, and distal arteries. [6,10] The IABP provides excellent hemodynamic support while awaiting transplant. [7] Arterial sites used for IABP insertion include the femoral artery, subclavian artery, axillary artery, [8] ascending aorta through suprainguinal bypass grafts, and common iliac artery.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, a femoral artery IABP can be inserted percutaneously at the bedside, rendering this approach the most commonly utilized. [10] However, the femoral artery approach requires patients to remain in bed until a donor heart becomes available, which can take from 40 days or longer. [11] The femoral artery approach is subsequently associated with significant risks and complications related to the effects of prolonged immobility.…”

Section: Introductionmentioning

confidence: 99%

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Macapagal

Green²,

McClellan³

et al. 2017

JNEP

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The intraaortic balloon pump (IABP) is a treatment for end-stage heart failure patients not responsive to pharmacological therapy pre heart transplantation. An alternative approach-the percutaneously placed axillary-subclavian intraaortic balloon pump (PAxIABP) developed by cardiologists in our hospital enable patients to be mobilized while awaiting transplant versus the traditional bedrest in the femoral approach. Our objective is to determine if PAxIABP therapy enable pre-heart-transplant patients to safely mobilize. A retrospective study of pre-heart-transplant PAxIABP patients in the Coronary Intensive Care Unit (CICU) from 2007 to 2013 (n = 45; 35 men, 10 women) was conducted to determine mobility. Data are presented as mean (standard deviation) for continuous variables and number (percentage) for categorical variables. Patients were mobilized at 1.39 (± 1.41) days after PAxIABP insertion. The number of times mobilized per day was 1.79 (± 2). Transplant waiting time was 24.98 (± 25.03) days. Thirty-seven patients (82%) were transplanted. Two patients had a left ventricular assist device (LVAD) inserted and later transplanted. Six patients died before receiving a heart transplant, patients were 100% mobile. Complication rates: 4% bleeding; 7% ischemic complications; 2% IABP-related infection. Pre-heart-transplant patients receiving PAxIABP therapy can be safely mobilized. Nursing care protocols were developed to safely take care of this patient population. PAxIABP can be utilized for other procedures requiring long IABP therapy.

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“…A persistently poor LV function will result in LV distention, poor recovery, and inability to open the aortic valve with increased risk for LV thrombus formation. This issue can be managed with inotropes, after-load reduction, surgical LV decompression [26,27], or using an intra-aortic balloon pump [28] or Impella microaxial flow device in conjunction with ECMO. Weaning from VA ECMO is achieved by gradually reducing the ECMO blood flow.…”

Section: Extra-corporeal Membrane Oxygenationmentioning

confidence: 99%

Review of Extracorporeal Membrane Oxygenation and Dialysis-Based Liver Support Devices for the Use of Nephrologists

Hamdi

Palmer²

2017

Am J Nephrol

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Acute kidney injury in the intensive care unit (ICU) is a manifestation of an underlying severe illness that commonly involves other organ systems. Pulmonary, cardiac, and hepatic failures are the most prevalent. This article provides a simplified review of the technical aspects of extracorporeal cardiopulmonary and liver support devices used in the adult ICU patient, as well as a summary of the most relevant and up-to-date clinical evidence that supports their use.

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Combining ECMO with IABP for the Treatment of Critically Ill Adult Heart Failure Patients

Cited by 72 publications

References 13 publications

Short‐term outcomes of intra‐aortic balloon pump combined with venoarterial extracorporeal membrane oxygenation: A systematic review and meta‐analysis

Short‐term outcomes of intra‐aortic balloon pump combined with venoarterial extracorporeal membrane oxygenation: A systematic review and meta‐analysis

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Review of Extracorporeal Membrane Oxygenation and Dialysis-Based Liver Support Devices for the Use of Nephrologists

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