Mechanical ventilation in conjunction with the intra-aortic balloon pump improves the outcome of patients in profound cardiogenic shock.
OBJECTIVE
To examine the effects of mechanical ventilation with positive end-expiratory pressure (PEEP), in conjunction with the intra-aortic balloon pump (IABP), on the outcome of patients in profound cardiogenic shock.


METHODS
Twenty-eight consecutive patients presenting with myocardial infarction complicated by cardiogenic shock refractory to medical therapy, including dobutamine, dopamine and fluid administration. Eighteen patients were assisted by the IABP alone (IABP group), and ten patients by the IABP plus controlled mechanical ventilation with PEEP set at 10 cmH(2)O (IABP + CMV group).


RESULTS
Weaning from mechanical assistance was accomplished in 8 out of 18 patients in the IABP group versus 9 out of 10 patients in the IABP + CMV group (p = 0.04). Ultimately, 5 of 18 patients in the IABP group were discharged from the hospital versus 8 of 10 patients in the IABP + CMV group (p = 0. 01).


CONCLUSIONS
Mechanical ventilation with PEEP at 10 cmH(2)O supplements the IABP and may improve the survival rates of patients suffering from cardiogenic shock.
Kontoyannis
D A
DA
University of Athens School of Medicine, Department of Clinical Therapeutics, "Alexandra" Hospital, Vas. Sophias and K. Lourou 2, GR-115 28 Athens, Greece.
Nanas
J N
JN
Kontoyannis
S A
SA
Stamatelopoulos
S F
SF
Moulopoulos
S D
SD
D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D012770:Shock, Cardiogenic / Q000628:therapy*; D016896:Treatment Outcome