| Cardiogenic shock with stunned myocardium during triple-H therapy treated with intra-aortic balloon pump counterpulsation. | |
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MedLine Citation:
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PMID: 18810666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Excessive use of adrenergic agents may result in stunned myocardium. CASES: We report the cases of two patients with subarachnoid hemorrhage (SAH) complicated by cardiogenic shock secondary to triple-H therapy for cerebral vasospasm. Both patients had normal cardiac function on admission and no signs of acute myocardial infarction at the onset of cardiogenic shock. Intra-aortic balloon pump (IABP) counterpulsation was used to maintain adequate cerebral perfusion while enabling the high doses of norepinephrine that were being administered to be reduced. Reversal of the myocardial dysfunction after vasopressors were discontinued supported a diagnosis of catecholamine-induced stunned myocardium. CONCLUSION: IABP counterpulsation may be one therapeutic option for patients with vasospasm after SAH when high doses of vasopressors can induce severe myocardial dysfunction. However, this invasive device may not be sufficient to maintain adequate cerebral perfusion and fatal embolic events can complicate the clinical course. |
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Authors:
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Fabio Silvio Taccone; Boris Lubicz; Michael Piagnerelli; Marc Van Nuffelen; Jean-Louis Vincent; Daniel De Backer |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2008-09-23 |
Journal Detail:
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Title: Neurocritical care Volume: 10 ISSN: 1541-6933 ISO Abbreviation: Neurocrit Care Publication Date: 2009 |
Date Detail:
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Created Date: 2009-01-21 Completed Date: 2009-03-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
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Languages: eng Pagination: 76-82 Citation Subset: IM |
Affiliation:
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Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, 808, 1070, Brussels, Belgium. ftaccone@ulb.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Humans Intra-Aortic Balloon Pumping* Middle Aged Myocardial Stunning / chemically induced, diagnosis, therapy* Norepinephrine / adverse effects* Shock, Cardiogenic / chemically induced, diagnosis, therapy* Subarachnoid Hemorrhage / complications, therapy Vasoconstrictor Agents / adverse effects* Vasospasm, Intracranial / etiology, therapy |
| Chemical | |
Reg. No./Substance:
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0/Vasoconstrictor Agents; 51-41-2/Norepinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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