Department of Cardiology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan 450000, China.
Department of Imaging, Henan Provincial Chest Hospital, Zhengzhou, Henan 450000, China.
J Healthc Eng. 2022 Mar 7;2022:1350673. doi: 10.1155/2022/1350673. eCollection 2022.
We evaluate the effect of extracorporeal membrane oxygenation combined with intraaortic balloon pump mechanical circulatory support for patients with cardiogenic shock complicating acute myocardial infarction during the PCI process. Extracorporeal membrane oxygenation combined with intraaortic balloon pump hemodynamic support during the percutaneous coronary intervention process for patients with cardiac shock complicating acute myocardial infarction might play a complementary role. Yet, evidence of application of both devices at the same time remains unclear. Patients with cardiogenic shock complicating myocardial infarction who underwent PCI in our hospital from January 2015 to January 2018 were screened. Those who were under hemodynamic support of extracorporeal membrane oxygenation combined with intraaortic balloon pump were enrolled as the ECMO&IABP group, and the patients only under support of intraaortic balloon pump were enrolled as the IABP group. The differences of clinical prognosis between the two groups were compared. A total of 39 patients were enrolled into the study: 10 were in the ECMO&IABP group and 29 in the IABP group. Compared with the IABP group, more patients were complicated with old myocardial infarction (5/10 vs. 2/29, =0.002), more patients were diagnosed as non-ST elevated myocardial infarction (8/10 vs. 11/29, =0.002) and left ventricular ejecting fraction was lower (41.1 ± 9.86 vs. 48.55 ± 8.86, =0.03) in the ECMO&IABP group. Mechanical complications were higher in the ECMO&IABP group (5/10 vs. 5/29, =0.048), The survive rate in the ECMO&IABP group is higher than that in the IABP group (90.00% vs. 47.83%, =0.042) at one-year follow-up. Compared with only IABP, ECMO combined with IABP hemodynamic support during the PCI process for patients with cardiogenic shock complicating acute myocardial infarction enjoys better mortality outcome.
我们评估了体外膜肺氧合（ECMO）联合主动脉内球囊泵机械循环支持对经皮冠状动脉介入治疗（PCI）过程中合并急性心肌梗死心原性休克患者的疗效。在 PCI 过程中，对于合并急性心肌梗死的心源性休克患者，ECMO 联合主动脉内球囊泵血流动力学支持可能具有互补作用。然而，同时应用这两种设备的证据尚不清楚。
筛选 2015 年 1 月至 2018 年 1 月在我院行 PCI 的合并心肌梗死后心原性休克患者。入选 ECMO 联合主动脉内球囊泵血流动力学支持患者为 ECMO&IABP 组，仅接受主动脉内球囊泵支持的患者为 IABP 组。比较两组患者临床预后的差异。
共纳入 39 例患者：10 例在 ECMO&IABP 组，29 例在 IABP 组。与 IABP 组相比，更多患者合并陈旧性心肌梗死（5/10 比 2/29，=0.002），更多患者诊断为非 ST 段抬高型心肌梗死（8/10 比 11/29，=0.002）和左心室射血分数更低（41.1±9.86 比 48.55±8.86，=0.03）。ECMO&IABP 组机械并发症发生率较高（5/10 比 5/29，=0.048），ECMO&IABP 组的 1 年生存率（90.00%比 47.83%，=0.042）高于 IABP 组。
与仅 IABP 相比，ECMO 联合 IABP 血流动力学支持在 PCI 过程中对合并急性心肌梗死的心源性休克患者的死亡率有更好的效果。
