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Intraaortic balloon counterpulsation and microcirculation in cardiogenic shock complicating myocardial infarction: an

Christian Jung1, Georg Fuernau, Suzanne de Waha

  • 1Clinic of Internal Medicine I, Friedrich-Schiller-University, Erlanger Allee 101, 07747, Jena, Germany, christian.jung@med.uni-jena.de.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|February 28, 2015
PubMed

Insights

Intra-aortic balloon pump (IABP) counterpulsation did not improve microvascular perfusion in patients with cardiogenic shock (CS). However, microcirculation parameters may help identify high-risk patients with CS.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Microcirculation Research

Background:

  • Profound microcirculatory alterations are observed in patients with cardiogenic shock (CS).
  • Clinical relevance of these microcirculatory changes is established.
  • Treatment strategies to improve microvascular perfusion in CS exist, but the role of intra-aortic balloon pump (IABP) is not clearly defined.

Purpose of the Study:

  • To evaluate the influence of intra-aortic balloon pump (IABP) counterpulsation on microcirculation in patients with CS complicating acute myocardial infarction.
  • To assess the impact of IABP on key microcirculatory parameters.

Main Methods:

  • A substudy of the IABP-SHOCK II trial investigated sublingual microcirculation using sidestream darkfield intravital microscopy.
  • Measurements included perfused capillary density (PCD), perfused vessel density (PVD), total capillary density (TCD), and total vessel density (TVD).
  • The proportion of perfused vessels was assessed on days 1, 2, and 4 after shock onset.

Main Results:

  • No significant differences in PCD, PVD, TCD, TVD, or proportion of perfused vessels were observed between patients with and without IABP support.
  • Microvascular perfusion inversely correlated with subsequent serum lactate levels (p = 0.02).
  • Microcirculatory parameters significantly predicted time to death (p < 0.05).

Conclusions:

  • IABP treatment does not affect microvascular perfusion in patients with CS.
  • Microcirculation parameters may serve as valuable tools for identifying high-risk patients requiring closer monitoring or intervention.
Abstract

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