Clinical Research in Cardiology

, Volume 98, Issue 8, pp 469–475 | Cite as

Acute microflow changes after stop and restart of intra-aortic balloon pump in cardiogenic shock

  • Christian JungEmail author
  • Christoph Rödiger
  • Michael Fritzenwanger
  • Julia Schumm
  • Alexander Lauten
  • Hans R. Figulla
  • Markus Ferrari
Original Paper



The intra-aortic balloon counter pulsation (IABP) is the most frequently used method of mechanical cardiac support in cardiogenic shock (CS). Microcirculatory impairment correlates with outcome in critically ill patients. We therefore investigated the acute influence of IABP therapy on sublingual microflow in patients with CS.


Sidestream darkfield intravitalmicroscopy was used in 13 patients with severe CS. The sublingual microvascular bed (10–100 μm) was examined according to current guidelines. We measured microflow in means of microvascular flow index at baseline and after intentional stop of IABP support. A computerized model was used for blinded off-line analysis.


Microflow in vessels 10–50 μm in diameter was improved during IABP support (P < 0.001). Norepinephrine had a negative effect on the response to IABP related microflow improvement. Cardiac Perfusion Index (product of Cardiac Power index and microflow) correlated best with blood lactate levels.


It was the aim of this study to evaluate the acute influence of IABP therapy on microflow in vivo. In this setting we found that IABP therapy improves sublingual microflow. Future studies should investigate Cardiac Perfusion Index under such conditions with respect to clinical decision making.


IABP Microcirculation Cardiogenic shock OPS SDF 

Supplementary material

Supplementary material 1 (WMV 3912 kb)


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Christian Jung
    • 1
    Email author
  • Christoph Rödiger
    • 1
  • Michael Fritzenwanger
    • 1
  • Julia Schumm
    • 1
  • Alexander Lauten
    • 1
  • Hans R. Figulla
    • 1
  • Markus Ferrari
    • 1
  1. 1.Clinic of Internal Medicine IFriedrich-Schiller-UniversityJenaGermany

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