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Differential responses to larger volume intra‐aortic balloon counterpulsation: Hemodynamic and clinical outcomes

OBJECTIVES: Examine hemodynamic and clinical correlates of use of an intra‐aortic balloon pump catheter in a single center. BACKGROUND: The intra‐aortic balloon pump catheter (IABC) has been used for 50 years but the clinical benefit is still debated. We reviewed 76 patients with right heart cathete...

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Autores principales: Baran, David A., Visveswaran, Gautam K., Seliem, Ahmed, DiVita, Michael, Wasty, Najam, Cohen, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221162/
https://www.ncbi.nlm.nih.gov/pubmed/29086475
http://dx.doi.org/10.1002/ccd.27387
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author Baran, David A.
Visveswaran, Gautam K.
Seliem, Ahmed
DiVita, Michael
Wasty, Najam
Cohen, Marc
author_facet Baran, David A.
Visveswaran, Gautam K.
Seliem, Ahmed
DiVita, Michael
Wasty, Najam
Cohen, Marc
author_sort Baran, David A.
collection PubMed
description OBJECTIVES: Examine hemodynamic and clinical correlates of use of an intra‐aortic balloon pump catheter in a single center. BACKGROUND: The intra‐aortic balloon pump catheter (IABC) has been used for 50 years but the clinical benefit is still debated. We reviewed 76 patients with right heart catheter measurements prior to IABC to assess response and outcomes. METHODS: All patients who received IABC with a 50cc balloon for at least 1 hour were included in this retrospective chart review study. Demographics, comorbidities, lab values, and hemodynamic parameters were recorded at baseline and 15 h postinsertion. RESULTS: Seventy‐six patients had paired measurements of cardiac output. 60 patients had a higher cardiac output with IABC treatment (responder group) and 16 did not (nonresponders). In the 60 patients in the responder group, cardiac output and index significantly increased from baseline 3.6 ± 1.3 L/min to 5.2 ± 1.8 L/min, and 1.8 ± 0.5 L/min/m(2) to 2.6 ± 0.8 L/min/m(2) respectively following IABC placement (P < 0.0001 for both comparisons). Various hemodynamic variables were examined and the best predictor of response to IABC was a cardiac power index of 0.3 or less. Regardless of response, in hospital survival was similar between groups. CONCLUSIONS: The majority of patients improve their cardiac output with IABC but survival was unchanged. Further work into the pathophysiology of cardiogenic shock is needed.
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spelling pubmed-62211622018-11-15 Differential responses to larger volume intra‐aortic balloon counterpulsation: Hemodynamic and clinical outcomes Baran, David A. Visveswaran, Gautam K. Seliem, Ahmed DiVita, Michael Wasty, Najam Cohen, Marc Catheter Cardiovasc Interv Coronary Artery Disease OBJECTIVES: Examine hemodynamic and clinical correlates of use of an intra‐aortic balloon pump catheter in a single center. BACKGROUND: The intra‐aortic balloon pump catheter (IABC) has been used for 50 years but the clinical benefit is still debated. We reviewed 76 patients with right heart catheter measurements prior to IABC to assess response and outcomes. METHODS: All patients who received IABC with a 50cc balloon for at least 1 hour were included in this retrospective chart review study. Demographics, comorbidities, lab values, and hemodynamic parameters were recorded at baseline and 15 h postinsertion. RESULTS: Seventy‐six patients had paired measurements of cardiac output. 60 patients had a higher cardiac output with IABC treatment (responder group) and 16 did not (nonresponders). In the 60 patients in the responder group, cardiac output and index significantly increased from baseline 3.6 ± 1.3 L/min to 5.2 ± 1.8 L/min, and 1.8 ± 0.5 L/min/m(2) to 2.6 ± 0.8 L/min/m(2) respectively following IABC placement (P < 0.0001 for both comparisons). Various hemodynamic variables were examined and the best predictor of response to IABC was a cardiac power index of 0.3 or less. Regardless of response, in hospital survival was similar between groups. CONCLUSIONS: The majority of patients improve their cardiac output with IABC but survival was unchanged. Further work into the pathophysiology of cardiogenic shock is needed. John Wiley and Sons Inc. 2017-10-31 2018-10-01 /pmc/articles/PMC6221162/ /pubmed/29086475 http://dx.doi.org/10.1002/ccd.27387 Text en © 2017 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Coronary Artery Disease
Baran, David A.
Visveswaran, Gautam K.
Seliem, Ahmed
DiVita, Michael
Wasty, Najam
Cohen, Marc
Differential responses to larger volume intra‐aortic balloon counterpulsation: Hemodynamic and clinical outcomes
title Differential responses to larger volume intra‐aortic balloon counterpulsation: Hemodynamic and clinical outcomes
title_full Differential responses to larger volume intra‐aortic balloon counterpulsation: Hemodynamic and clinical outcomes
title_fullStr Differential responses to larger volume intra‐aortic balloon counterpulsation: Hemodynamic and clinical outcomes
title_full_unstemmed Differential responses to larger volume intra‐aortic balloon counterpulsation: Hemodynamic and clinical outcomes
title_short Differential responses to larger volume intra‐aortic balloon counterpulsation: Hemodynamic and clinical outcomes
title_sort differential responses to larger volume intra‐aortic balloon counterpulsation: hemodynamic and clinical outcomes
topic Coronary Artery Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221162/
https://www.ncbi.nlm.nih.gov/pubmed/29086475
http://dx.doi.org/10.1002/ccd.27387
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