Open Access Research article

Clinical impact of intra-aortic balloon pump during extracorporeal life support in patients with acute myocardial infarction complicated by cardiogenic shock

Taek Kyu Park1, Jeong Hoon Yang12, Seung-Hyuk Choi1*, Young Bin Song1, Joo-Yong Hahn1, Jin-Ho Choi1, Kiick Sung3, Young Tak Lee3 and Hyeon-Cheol Gwon1

Author Affiliations

1 Department of Medicine, Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea

2 Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

3 Department of Thoracic and Cardiovascular Surgery, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

For all author emails, please log on.

BMC Anesthesiology 2014, 14:27  doi:10.1186/1471-2253-14-27

Published: 14 April 2014

Abstract

Background

There is no available data on clinical outcome in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock who are supported by an intra-aortic balloon pump (IABP) in combination with extracorporeal life support (ECLS).

Methods

We analysed 96 consecutive patients with AMI and complicating cardiogenic shock who were assisted by an ECLS system between January 2004 and December 2011. The primary outcome was in-hospital mortality. The secondary outcomes were the success rate of weaning from ECLS and the lactate clearance for 48 hours (%).

Results

A combination of IABP and ECLS was used in 41 (42.7%) patients. In-hospital mortality occurred for 51 patients (ECLS with IABP versus ECLS alone; 51.2% vs. 54.5%, p = 0.747). The success rate of weaning from ECLS was similar between the two groups (63.4% vs. 58.2%, p = 0.604). Complications such as ischemia of a lower extremity or bleeding at the ECLS insertion site (p = 0.521 and p = 0.667, respectively) did not increase when ECLS was combined with IABP. Among patients who survived for 24 hours after intervention, lactate clearance was not significantly different between patients who received ECLS alone and those who received ECLS with IABP (p = 0.918).

Conclusions

The combined use of ECLS and IABP did not improve in-hospital survival in patients with AMI complicated by cardiogenic shock.

Keywords:
Myocardial infarction; Cardiogenic shock; Extracorporeal life support; Intra-aortic balloon pump