Hemodynamic Effects of the Concomitant Use of Intra-Aortic Balloon Pumping and Venoarterial Bypass without Oxygenation in Cardiogenic Shock

摘要

The concomitant use of INTRA-AORTIC BALLOON PUMPING (IABP) and venoarterial bypass(VAB) without oxygenation (VAB_??_O) was performed in 10 experiments using 6 dogs in cardiogenic shock. VAB_??_O was accomplished with the cricuit from the right atrium to the femoral artery and bypass flow rates were set at approximately one third of the baseline cardiac output. Displacement volume of the IABP balloon was 10 or 20ml.Evaluation of hemodynamic effects of the concomitant use was carried out, as compared with the single use of IABP or VAB_??_O.The following findings were obtained:(1) In the concomitant use, left ventricular afterload decreased, while mean aortic root pressure increased. Increase in total perfusion flow, decrease in mean left atrial pressure and decrease in left ventricular stroke work were shown more effective than each of the single uses.(2) These results suggest that the concomitant use of IABP and VABsO can be used as a second step assisted circulation when IABP is shown uneffective in the case of severe cardiogenic shock.