Primary intra-aortic balloon support versus inotropes for decompensated heart failure and low output: a randomised trial.
EuroIntervention
; 15(7): 586-593, 2019 09 20.
Article
em En
| MEDLINE
| ID: mdl-31147306
ABSTRACT
AIMS:
The haemodynamic effects of primary implantation of an intra-aortic balloon pump (IABP) versus inotropes in decompensated heart failure and low output (DHF-LO), but without an acute coronary syndrome, have not been investigated. We therefore aimed to investigate the effect of primary IABP implantation as compared to inotropes on haemodynamics in DHF-LO with no acute ischaemia. METHODS ANDRESULTS:
Patients (n=32) with DHF-LO despite IV diuretics were randomised to primary 50 mL IABP or inotropes (INO enoximone or dobutamine). The primary endpoint was the improvement of organ perfusion assessed by ∆ mixed-venous oxygen saturation (SvO2) at 3 hours; secondary endpoints included ∆ cardiac power output (CPO), NT-proBNP proportional change, cumulative fluid balance and ∆ dyspnoea severity score, all at 48 hours. Data are presented as median (IQR). Patients were 60 (48-69) years old and 72% were male. Baseline SvO2 was 44 (39-53)%. ∆SvO2 was higher in the IABP group (+17 [+9; +24] vs. +5 [+2; +9]%, p<0.05). IABP patients had a higher ∆CPO, a greater relative reduction in NT-proBNP, a more negative cumulative fluid balance, and a greater reduction in dyspnoea severity score. There were no IABP-related serious adverse events (SAEs). Thirty-day mortality was 23% (IABP) vs. 44% (INO).CONCLUSIONS:
Primary circulatory support by IABP showed a significant increase in improved organ perfusion assessed by SvO2.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Débito Cardíaco
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Cardiotônicos
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Enoximona
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Dobutamina
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Insuficiência Cardíaca
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Hemodinâmica
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Balão Intra-Aórtico
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Holanda