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Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model

(1) Introduction: Simultaneous ECMO and IABP therapy is frequently used. Haemodynamic changes responsible for the success of the concomitant mechanical circulatory support system approach are rarely investigated. In a large-animal model, we analysed haemodynamic parameters before and during ECMO the...

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Autores principales: Djordjevic, Ilija, Liakopoulos, Oliver, Elskamp, Mara, Maier-Trauth, Johanna, Gerfer, Stephen, Mühlbauer, Thomas, Slottosch, Ingo, Kuhn, Elmar, Sabashnikov, Anton, Rademann, Pia, Maul, Alexandra, Paunel-Görgülü, Adnana, Wahlers, Thorsten, Deppe, Antje Christin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694613/
https://www.ncbi.nlm.nih.gov/pubmed/36430994
http://dx.doi.org/10.3390/life12111859
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author Djordjevic, Ilija
Liakopoulos, Oliver
Elskamp, Mara
Maier-Trauth, Johanna
Gerfer, Stephen
Mühlbauer, Thomas
Slottosch, Ingo
Kuhn, Elmar
Sabashnikov, Anton
Rademann, Pia
Maul, Alexandra
Paunel-Görgülü, Adnana
Wahlers, Thorsten
Deppe, Antje Christin
author_facet Djordjevic, Ilija
Liakopoulos, Oliver
Elskamp, Mara
Maier-Trauth, Johanna
Gerfer, Stephen
Mühlbauer, Thomas
Slottosch, Ingo
Kuhn, Elmar
Sabashnikov, Anton
Rademann, Pia
Maul, Alexandra
Paunel-Görgülü, Adnana
Wahlers, Thorsten
Deppe, Antje Christin
author_sort Djordjevic, Ilija
collection PubMed
description (1) Introduction: Simultaneous ECMO and IABP therapy is frequently used. Haemodynamic changes responsible for the success of the concomitant mechanical circulatory support system approach are rarely investigated. In a large-animal model, we analysed haemodynamic parameters before and during ECMO therapy, comparing central and peripheral ECMO circulation with and without simultaneous IABP support. (2) Methods: Thirty-three female pigs were divided into five groups: (1) SHAM, (2) (peripheral)ECMO(–)IABP, (3) (p)ECMO(+)IABP, (4) (central)ECMO(–)IABP, and (5) (c)ECMO(+)IABP. Pigs were cannulated in accordance with the group and supported with ECMO (±IABP) for 10 h. Systemic haemodynamics, cardiac index (CI), and coronary and carotid artery blood flow were determined before, directly after, and at five and ten hours on extracorporeal support. Systemic inflammation (IL-6; IL-10; TNFα; IFNγ), immune response (NETs; cf-DNA), and endothelial injury (ET-1) were also measured. (3) Results: IABP support during antegrade ECMO circulation led to a significant reduction of left ventricular pressure in comparison to retrograde flow in (p)ECMO(–)IABP and (p)ECMO(+)IABP. Blood flow in the left anterior coronary and carotid artery was not affected by extracorporeal circulation. (4) Conclusions: Concomitant central ECMO and IABP therapy leads to significant reduction of intracavitary cardiac pressure, reduces cardiac work, and might therefore contribute to improved recovery in ECMO patients.
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spelling pubmed-96946132022-11-26 Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model Djordjevic, Ilija Liakopoulos, Oliver Elskamp, Mara Maier-Trauth, Johanna Gerfer, Stephen Mühlbauer, Thomas Slottosch, Ingo Kuhn, Elmar Sabashnikov, Anton Rademann, Pia Maul, Alexandra Paunel-Görgülü, Adnana Wahlers, Thorsten Deppe, Antje Christin Life (Basel) Article (1) Introduction: Simultaneous ECMO and IABP therapy is frequently used. Haemodynamic changes responsible for the success of the concomitant mechanical circulatory support system approach are rarely investigated. In a large-animal model, we analysed haemodynamic parameters before and during ECMO therapy, comparing central and peripheral ECMO circulation with and without simultaneous IABP support. (2) Methods: Thirty-three female pigs were divided into five groups: (1) SHAM, (2) (peripheral)ECMO(–)IABP, (3) (p)ECMO(+)IABP, (4) (central)ECMO(–)IABP, and (5) (c)ECMO(+)IABP. Pigs were cannulated in accordance with the group and supported with ECMO (±IABP) for 10 h. Systemic haemodynamics, cardiac index (CI), and coronary and carotid artery blood flow were determined before, directly after, and at five and ten hours on extracorporeal support. Systemic inflammation (IL-6; IL-10; TNFα; IFNγ), immune response (NETs; cf-DNA), and endothelial injury (ET-1) were also measured. (3) Results: IABP support during antegrade ECMO circulation led to a significant reduction of left ventricular pressure in comparison to retrograde flow in (p)ECMO(–)IABP and (p)ECMO(+)IABP. Blood flow in the left anterior coronary and carotid artery was not affected by extracorporeal circulation. (4) Conclusions: Concomitant central ECMO and IABP therapy leads to significant reduction of intracavitary cardiac pressure, reduces cardiac work, and might therefore contribute to improved recovery in ECMO patients. MDPI 2022-11-12 /pmc/articles/PMC9694613/ /pubmed/36430994 http://dx.doi.org/10.3390/life12111859 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Djordjevic, Ilija
Liakopoulos, Oliver
Elskamp, Mara
Maier-Trauth, Johanna
Gerfer, Stephen
Mühlbauer, Thomas
Slottosch, Ingo
Kuhn, Elmar
Sabashnikov, Anton
Rademann, Pia
Maul, Alexandra
Paunel-Görgülü, Adnana
Wahlers, Thorsten
Deppe, Antje Christin
Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model
title Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model
title_full Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model
title_fullStr Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model
title_full_unstemmed Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model
title_short Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model
title_sort concomitant intra-aortic balloon pumping significantly reduces left ventricular pressure during central veno-arterial extracorporeal membrane oxygenation—results from a large animal model
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694613/
https://www.ncbi.nlm.nih.gov/pubmed/36430994
http://dx.doi.org/10.3390/life12111859
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