Cardiac support with IABP during venovenous ECMO for ARDS
- 704 Downloads
Right ventricular failure during acute respiratory distress syndrome (ARDS) is common  and has poor prognostic implications . Venovenous extracorporeal membrane oxygenation (VV ECMO) often restores hemodynamic stability by correcting the metabolic milieu. The mechanical circulatory support provided by VV ECMO, however, is only indirect and mediated by the reduction in pulmonary artery pressure secondary to the correction of hypoxemia and acidosis. On the other hand, transition from VV to venoarterial (VA) ECMO support is not free from risks. In this context, intraaortic balloon pump (IABP) counterpulsation may be advantageous, as it is aimed at improving the ventricular performance of the failing heart by facilitating an increase in myocardial oxygen supply and a decrease in myocardial oxygen demand . Furthermore, IABP has already been shown to be useful in improving right ventricular pressure-induced failure .
Based on these considerations, we treated six...
KeywordsAcute Respiratory Distress Syndrome Mechanical Circulatory Support ECMO Support Intraaortic Balloon Pump IABP Support
Conflicts of interest
The authors have no conflict of interest to declare.
- 2.Osman D, Monnet X, Castelain V, Anguel N, Warszawski J, Teboul JL, Richard C; French Pulmonary Artery Catheter Study Group (2009) Incidence and prognostic value of right ventricular failure in acute respiratory distress syndrome. Intensive Care Med 35:69–76. doi: 10.1007/s00134-008-1307-1 PubMedCrossRefGoogle Scholar
- 5.Pappalardo F, Pieri M, Greco T, Patroniti N, Pesenti A, Arcadipane A, Ranieri VM, Gattinoni L, Landoni G, Holzgraefe B, Beutel G, Zangrillo A; Italian ECMOnet (2013) Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score. Intensive Care Med 39:275–81. doi: 10.1007/s00134-012-2747 PubMedCrossRefGoogle Scholar