Effects of venous arterial extracorporeal membrane oxygenation combined with IABP on echocardiographic parameters and prognosis in patients with cardiogenic shock
Objective To study the effects of venous arterial extracorporeal membrane oxygenation(VA-ECMO)combined with intra-aortic balloon pump(IABP)on echocardiogram parameters and prognosis in patients with cardiogenic shock(CS).Methods A total of 105 patients with CS who were admitted to CCU of the Third People's Hospital of Chengdu between June 2017 and June 2022were conducted on this study.All patients were divided into two groups:control group 54 cases(IABP only)and experimental group 51 cases(VA-ECMO combined IABP).Complications and prognosis of the two groups were compared.All tests were analyzed including the echocardiogram parameters[left ventricular ejection fraction(LVEF),respiratory variation index(△RVI),velocity-time integral variation index(△VTI),central venous pressure(CVP),heart rate(HR),oxygen saturation venous blood(SvO2),cardiac index(CI)];cardiac function indexes[mean arterial pressure(MAP),creatine kinase MB(CK-MB),cardiac troponin I(cTnI),creatine kinase(CK),B-type natriuretic peptide(BNP)];and blood gas analysis indexes(pH,HCO3-,lactic acid,PaCO2,oxygenation index)before and after treatment;use of vasoactive agentsnorepinephrine(NE)and epinephrine(E).Results The△VTI,SvO2 and CI inexperimental group were higher than those in control group(P<0.05).There was no significant difference inHR,CVP,LVEF or △RVI between the two groups(P>0.05).MAP in experimental group was higher than that in control group(P<0.05),while CK,CK-MB,cTnI and BNP were lower than those in control group(P<0.05).HCO3-in experimental group was higher than that in control group(P<0.05),lactic acid was lower than that in control group(P<0.05),but there was no significant difference inpH,PaCO2 or oxygenation index between the two groups(P>0.05).Dosages of NE and E in experimental group were lower than those in control group(P<0.05).There was no significant difference in the incidence of complications between the two groups during treatment(P>0.05).The success rate of weaning in experimental group was higher than that in control group(P<0.05).Mortality during hospitalizationtreatments in experimental group was lower than that in control group(P<0.05),but there was no difference in mortality within 30 d between the two groups(P>0.05).Conclusion VA-ECMO combined with IABP can improve echocardiogram parameters,promote the recovery of cardiac function,reduce dosages of cardiovascular drugs,increase weaning rate and reduce the occurrence of death in patients with CS in our study.
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