Université de Rennes 1, Department of Cardiology, CHU de Rennes, Inserm, UMR 1099 LTSI, 35000 Rennes, France.
Université de Rennes 1, Department of Cardiology, CHU de Rennes, Inserm, UMR 1099 LTSI, 35000 Rennes, France.
Arch Cardiovasc Dis. 2019 Dec;112(12):792-798. doi: 10.1016/j.acvd.2019.04.009. Epub 2019 Jun 24.
The intra-aortic balloon pump has been widely used in the management of cardiogenic shock. Reducing cardiac afterload and myocardial oxygen consumption, and improving coronary blood flow, this safe and simple mechanical circulatory support has been considered the cornerstone of cardiogenic shock management for decades. However, because it failed to provide any clinical benefit in recent randomized trials, the latest guidelines discourage its routine use in this clinical setting. Moreover, new percutaneous circulatory supports providing greater haemodynamic improvement have recently been developed. Thus, intra-aortic balloon pump use has declined considerably in this clinical setting. However, the device does retain a minor role in cardiogenic shock management - mainly in the setting of mechanical complication of acute coronary syndrome, and for left ventricular unloading in patients treated with extracorporeal life support.
主动脉内球囊反搏已广泛应用于心源性休克的治疗。通过降低心脏后负荷和心肌耗氧量，改善冠状动脉血流，这种安全、简单的机械循环支持已被认为是心源性休克治疗数十年来的基石。然而，由于最近的随机试验未能提供任何临床获益，最新指南不鼓励在这种临床情况下常规使用。此外，最近开发了新的经皮循环支持设备，可提供更大的血液动力学改善。因此，主动脉内球囊反搏在这种临床情况下的使用已大大减少。然而，该设备在心源性休克管理中仍保留着次要作用，主要用于急性冠状动脉综合征的机械并发症，以及体外生命支持治疗的患者的左心室卸载。
