Intraaortic Balloon Pump Counterpulsation, Part I: History, Technical Aspects, Physiologic Effects, Contraindications, Medical Applications/Outcomes

被引:20
作者
Gonzalez, Laura S. [1 ]
Chaney, Mark A. [2 ]
机构
[1] Med Coll Wisconsin, Dept Anesthesiol, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA
[2] Univ Chicago, Dept Anesthesia & Crit Care, Box 428, Chicago, IL 60637 USA
关键词
ACUTE MYOCARDIAL-INFARCTION; INTRA-AORTIC BALLOON; CORONARY BLOOD-FLOW; HIGH-RISK PATIENTS; MECHANICAL CIRCULATORY SUPPORT; RIGHT-VENTRICULAR FAILURE; CARDIOGENIC-SHOCK; CLINICAL-EXPERIENCE; ASSISTED CIRCULATION; OXYGEN-CONSUMPTION;
D O I
10.1213/ANE.0000000000004954
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Intraaortic balloon pump counterpulsation is the most common form of mechanical circulatory support used in patients with myocardial ischemia and cardiogenic shock. The physiologic principles of counterpulsation include diastolic augmentation of aortic pressure and systolic reduction of left ventricular afterload, resulting in hemodynamic benefits through increased coronary perfusion pressure and improved myocardial oxygen balance in patients with myocardial ischemia. Major trials have failed to conclusively demonstrate improvements in morbidity and mortality with counterpulsation therapy for patients with acute myocardial infarction (MI), cardiogenic shock, and/or severe coronary artery disease undergoing revascularization therapy, and the debate over its applications continues. Part I of this review focuses on the history of the development of counterpulsation, technical considerations, and complications associated with its use, its physiologic effects, and evidence for its use in myocardial ischemia and cardiogenic shock.
引用
收藏
页码:776 / 791
页数:16
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