Combining ECMO with IABP for the treatment of critically Ill adult heart failure patients.
OBJECTIVE
To discuss the experience of combining extra-corporeal membrane oxygenation (ECMO) with intra-aortic balloon pump (IABP) for the treatment of acute heart failure in critically ill adults.


METHODS
The clinical data of 54 patients who received ECMO combined with IABP due to acute heart failure between January 2008 and July 2012 were retrospectively analysed. Thirty-eight of the patients were male, and 16 were female; the mean age was 57±11. Thirty-nine of the patients received IABP first but were still unable to maintain adequate circulation, and were then given ECMO; the other 15 underwent ECMO first, but due to increased left ventricular load, the opening of the aortic valve was restricted and IABP was then introduced.


RESULTS
Thirty-four patients (63%) were successfully weaned from ECMO; 21 patients (38.9%) survived to discharge. Major complications that occurred were renal failure (27 cases), infection (20 cases), blood plasma leakage in the oxygenator (13 cases), bleeding (18 cases), limb ischaemia (eight cases), and neurological complications (seven cases); in the group of patients who did not survive, the rates of bleeding occurrence, infection and renal failure were markedly higher than in the survived patients group. In both groups, the longer the patients were on support, the more improvement they showed in terms of MAP, CVP, Lac, SvO2 and IS.


CONCLUSIONS
ECMO and IABP may have synergistic effects and play complementary roles in the treatment of acute cardiac failure; with timely administration, active prevention and treatment of complications, they can improve treatment outcome.
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Pengyu
P
Ma
Department of Anesthesiology, The Bethune International Peace Hospital of PLA China, No. 398 Zhongshan West Road, Shijiazhuang 050082, Hebei Province, China.
Zaiwang
Z
Zhang
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China. Electronic address: songtieyingBM@163.com.
Tieying
T
Song
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Yunliang
Y
Yang
Department of Cardiac Surgery, The First Hospital of Shijiazhuang, No. 36 Van West Road, Shijiazhuang 050011, China.
Ge
G
Meng
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Jianhui
J
Zhao
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Chunping
C
Wang
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Kunfeng
K
Gu
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Jingyan
J
Peng
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Bo
B
Jiang
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Yan
Y
Qi
Graduate School, Hebei Medical University, No. 361 Zhongshan East Road, Shijiazhuang 050017, China.
Ruyu
R
Yan
Department of Anesthesiology, The First Hospital of Shijiazhuang, No. 36 Fanxi Road, Chang'an District, Shijiazhuang 050011, Hebei Province, China.
Xiaojing
X
Ma
D000208:Acute Disease; D000328:Adult; D000368:Aged; D016638:Critical Illness; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
Acute heart failure; Central venous pressure; Extracorporeal membrane oxygenation; Intra-aortic balloon pump; Synergistic effects