Document Detail

Acute microflow changes after stop and restart of intra-aortic balloon pump in cardiogenic shock.
MedLine Citation:
PMID:  19367424     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: 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. METHODS: Sidestream darkfield intravitalmicroscopy was used in 13 patients with severe CS. The sublingual microvascular bed (10-100 microm) 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. RESULTS: Microflow in vessels 10-50 microm 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. CONCLUSIONS: 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.
Christian Jung; Christoph Rödiger; Michael Fritzenwanger; Julia Schumm; Alexander Lauten; Hans R Figulla; Markus Ferrari
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-04-15
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  98     ISSN:  1861-0692     ISO Abbreviation:  -     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-30     Completed Date:  2009-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  469-75     Citation Subset:  IM    
Clinic of Internal Medicine I, Friedrich-Schiller-University, Jena, Germany.
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MeSH Terms
Blood Flow Velocity*
Intra-Aortic Balloon Pumping / methods*
Shock, Cardiogenic / physiopathology*,  rehabilitation*
Sublingual Gland / blood supply*,  physiopathology*
Treatment Outcome

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