Τίτλος:
Comparison of pulsatile with nonpulsatile mechanical support in a
porcine model of profound cardiogenic shock
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The aim of this study was to examine whether pulsatility by intraaortic
balloon counterpulsation (IABP) is an important adjunct to the treatment
of profound cardiogenic shock (CS) with a widely used, nonpulsatile
centrifugal pump (CP). In each of 18 anesthetized, open chest pigs, the
outflow cannula of the CP was inserted in the aortic arch through the
right external carotid artery, and the inflow cannula of the CP was
placed in the left atrium. A 40 cc IABP was subsequently placed in the
descending aorta through the left external carotid artery. CS was
induced by occlusion of coronary arteries and the infusion of
propranolol and crystalloid fluid. Mean aortic pressure, pulse pressure,
aortic end diastolic pressure, left ventricular end diastolic pressure,
right atrial pressure, and heart rate were monitored. Cardiac output and
left anterior descending artery flow were measured with a transit time
ultrasound flowmeter. During profound CS, life sustaining hemodynamics
were maintained only with the support of the assist devices. Hemodynamic
support with the CP was associated with a nearly nonpulsatile flow and a
pulse pressure of 7 +/- 4 mm Hg, which increased to 33 +/- 10 mm Hg (p =
0.000) after combining the CP with the IABP. Compared with the
hemodynamic support offered by the CP alone, addition of the IABP
increased mean aortic pressure from 40 +/- 15 to 50 +/- 16 mm Hg (p =
0.000), cardiac output from 810 +/- 194 to 1,200 +/- 234 ml/min (p =
0.003), and left anterior descending artery flow from 26 10 to 39 14
ml/min (p = 0.001). In profound CS, mechanical support provided by a
continuous flow CP is enhanced by the added pulsatility of the IABP.
Συγγραφείς:
Drakos, SG
Charitos, CE
Ntalianis, A
Terrovitis, JV and
Siafakas, KX
Dolou, P
Pierrakos, C
Charitos, E
Karelas,
J
Nanas, JN
Περιοδικό:
ASAIO journal (American Society for Artificial Internal Organs : 1992)
Εκδότης:
Lippincott, Williams & Wilkins
DOI:
10.1097/01.mat.0000150323.62708.35
