Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model
Ilija Djordjevic,
Oliver Liakopoulos,
Mara Elskamp,
Johanna Maier-Trauth,
Stephen Gerfer,
Thomas Mühlbauer,
Ingo Slottosch,
Elmar Kuhn,
Anton Sabashnikov,
Pia Rademann,
Alexandra Maul,
Adnana Paunel-Görgülü,
Thorsten Wahlers,
Antje Christin Deppe
Affiliations
Ilija Djordjevic
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
Oliver Liakopoulos
Department of Cardiac Surgery, Kerckhoff-Clinic Bad Nauheim, Campus Kerckhoff, University of Giessen, 61231 Bad Nauheim, Germany
Mara Elskamp
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
Johanna Maier-Trauth
Division of Thoracic and Cardiovascular Surgery, HELIOS Klinikum Siegburg, 53721 Siegburg, Germany
Stephen Gerfer
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
Thomas Mühlbauer
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
Ingo Slottosch
Department of Cardiothoracic Surgery, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
Elmar Kuhn
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
Anton Sabashnikov
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
Pia Rademann
Experimental Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 51109 Cologne, Germany
Alexandra Maul
Experimental Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 51109 Cologne, Germany
Adnana Paunel-Görgülü
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
Thorsten Wahlers
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
Antje Christin Deppe
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
(1) Introduction: Simultaneous ECMO and IABP therapy is frequently used. Haemodynamic changes responsible for the success of the concomitant mechanical circulatory support system approach are rarely investigated. In a large-animal model, we analysed haemodynamic parameters before and during ECMO therapy, comparing central and peripheral ECMO circulation with and without simultaneous IABP support. (2) Methods: Thirty-three female pigs were divided into five groups: (1) SHAM, (2) (peripheral)ECMO(–)IABP, (3) (p)ECMO(+)IABP, (4) (central)ECMO(–)IABP, and (5) (c)ECMO(+)IABP. Pigs were cannulated in accordance with the group and supported with ECMO (±IABP) for 10 h. Systemic haemodynamics, cardiac index (CI), and coronary and carotid artery blood flow were determined before, directly after, and at five and ten hours on extracorporeal support. Systemic inflammation (IL-6; IL-10; TNFα; IFNγ), immune response (NETs; cf-DNA), and endothelial injury (ET-1) were also measured. (3) Results: IABP support during antegrade ECMO circulation led to a significant reduction of left ventricular pressure in comparison to retrograde flow in (p)ECMO(–)IABP and (p)ECMO(+)IABP. Blood flow in the left anterior coronary and carotid artery was not affected by extracorporeal circulation. (4) Conclusions: Concomitant central ECMO and IABP therapy leads to significant reduction of intracavitary cardiac pressure, reduces cardiac work, and might therefore contribute to improved recovery in ECMO patients.
