随机对照试验
主动脉内球囊反搏
心源性休克
射血分数
急性失代偿性心力衰竭
心输出量
心脏指数
血压
主动脉瓣成形术
主动脉内球囊反搏
作者
Corstiaan A. den Uil,Nicolas M. Van Mieghem,Marcelo B Bastos,Lucia S.D. Jewbali,Mattie J. Lenzen,Annemarie E. Engström,Jeroen J H Bunge,Jasper J. Brugts,Olivier C. Manintveld,Joost Daemen,Jeroen Wilschut,Felix Zijlstra,Alina A. Constantinescu
出处
期刊:Eurointervention
[Europa Digital and Publishing]
日期:2019-09-20
卷期号:15 (7): 586-593
被引量:19
标识
DOI:10.4244/eij-d-19-00254
摘要
AIMS The haemodynamic effects of primary implantation of an intra-aortic balloon pump (IABP) versus inotropes in decompensated heart failure and low output (DHF-LO), but without an acute coronary syndrome, have not been investigated. We therefore aimed to investigate the effect of primary IABP implantation as compared to inotropes on haemodynamics in DHF-LO with no acute ischaemia. METHODS AND RESULTS Patients (n=32) with DHF-LO despite IV diuretics were randomised to primary 50 mL IABP or inotropes (INO: enoximone or dobutamine). The primary endpoint was the improvement of organ perfusion assessed by ∆ mixed-venous oxygen saturation (SvO2) at 3 hours; secondary endpoints included ∆ cardiac power output (CPO), NT-proBNP proportional change, cumulative fluid balance and ∆ dyspnoea severity score, all at 48 hours. Data are presented as median (IQR). Patients were 60 (48-69) years old and 72% were male. Baseline SvO2 was 44 (39-53)%. ∆SvO2 was higher in the IABP group (+17 [+9; +24] vs. +5 [+2; +9]%, p<0.05). IABP patients had a higher ∆CPO, a greater relative reduction in NT-proBNP, a more negative cumulative fluid balance, and a greater reduction in dyspnoea severity score. There were no IABP-related serious adverse events (SAEs). Thirty-day mortality was 23% (IABP) vs. 44% (INO). CONCLUSIONS Primary circulatory support by IABP showed a significant increase in improved organ perfusion assessed by SvO2.
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