The Hemodynamic Effects of An Intra-Aortic Balloon Pump in Patients with Cardiogenic Shock: A Systematic Review
CCCF ePoster library. Al-Rajhi A. Nov 2, 2016; 151006
Amjad Al-Rajhi
Amjad Al-Rajhi
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Abstract
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Topic: Systematic Review, Meta-analysis, or Meta-synthesis

The Hemodynamic Effects of An Intra-Aortic Balloon Pump in Patients with Cardiogenic Shock: A Systematic Review


Yang SS1, Al-Rajhi A1, Magder S1
1
Department of Critical Care, McGill University, Montreal, Canada

Abstract:

Introduction
Cardiogenic shock(CS) occurs in 7-10% of patients with acute myocardial infarction. The mortality rate of CS can be as high as 50-60%, despite medical treatment. Intra-aortic balloon pump(IABP) is commonly used as a mechanical assist device in patients with CS in addition to medical therapy. However, to date there is no systematic review that looked at the hemodynamic benefits of an IABP in this group of patients.
 
Methods
Six databases (Medline, Pubmed - NonMedline, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Central registry of controlled trials) were searched to identify articles that evaluate the hemodynamic effects of an IABP pre-implantation and post-implantation. The aim of this systematic review was to assess the cardiac index, pulmonary arterial occlusion pressure (PAOP), central venous pressure(CVP), blood pressure, and heart rate.
 
Results
Twenty-three studies were selected. A total of 463 patients underwent implantation of an IABP. The indications for insertion of IABP included: CS secondary to acute myocardial infarction, high-risk coronary artery disease (CAD) patients undergoing coronary bypass grafting(CABG) surgery, End-stage cardiomyopathy, ventricular septal defect, and right ventricular failure after cardiac transplant. After insertion of IABP, there was a significant increase in cardiac index (MD: 0.65; 95% CI 0.43, 0.88), a decrease in PAOP (MD: -4.44; 95% CI -6.87, -2.06, a decrease in CVP (MD: -2.22; 95% CI -3.95, -0.48) no significant difference in heart rate (MD: -5.87; 95% CI -12.70, 0.96), or mean arterial pressure (MD: 7.33; 95% CI -0.06, 14.72).
 
Conclusion
In patients with CS, the implantation of an IABP increased the cardiac index. This is most prominent in patients with high risk CAD.
 


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