Acute cardiac care & resuscitation
Haemodynamic Effects of Intra-Aortic Balloon Pumps Stratified by Baseline Pulmonary Artery Pulsatility Index
Authors' conclusion
IABP devices in those with HF-CS and low or abnormal PAPi may provide modest short-term haemodynamic benefits without significant improvement in CI, along with greater need for adjustment in medical therapeutics to achieve haemodynamic optimization.
Study context
- Population
- Patients with HF-related cardiogenic shock (HF-CS) undergoing intra-aortic balloon pump (IABP) placement, 2020–2022
- Participants
- 67 patients
- Exposure
- IABP support stratified by baseline pulmonary artery pulsatility index (PAPi) <2.0 vs ≥2.0
- PAPi <2.0n = 38
- PAPi ≥2.0n = 29reference
- Outcome
- Haemodynamic changes on pulmonary artery catheter monitoring
- Follow-up
- 72 h following IABP placement
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Haemodynamic changes after IABP (baseline to 72 h) · 72 h
| Group | Central venous pressure (CVP) | Mean pulmonary artery pressure (mPAP) | PAPi | Cardiac index | mPA |
|---|---|---|---|---|---|
| PAPi <2.0 | 20 to 12 mmHg, P < 0.001 | 37.5 to 28.5 mmHg, P = 0.001 | 1 to 1.6, P = 0.001 | 2 to 2.1 L/min/m², P = 0.31 | |
| PAPi ≥2.0 | 10 to 8 mmHg, P = 0.47 | 2.6 to 2.8, P = 0.92 | 1.9 to 2.5 L/min/m², P = 0.004 | 37 to 29 mmHg, P = 0.03 |
Central venous pressure (CVP)
PAPi <2.020 to 12 mmHg, P < 0.001
PAPi ≥2.010 to 8 mmHg, P = 0.47
Mean pulmonary artery pressure (mPAP)
PAPi <2.037.5 to 28.5 mmHg, P = 0.001
PAPi ≥2.0Not reported in the abstract
PAPi
PAPi <2.01 to 1.6, P = 0.001
PAPi ≥2.02.6 to 2.8, P = 0.92
Cardiac index
PAPi <2.02 to 2.1 L/min/m², P = 0.31
PAPi ≥2.01.9 to 2.5 L/min/m², P = 0.004
mPA
PAPi <2.0Not reported in the abstract
PAPi ≥2.037 to 29 mmHg, P = 0.03
Observational data: associations, not effects.
Further findings
Increase in diuretic requirement · 72 h
P = 0.01
Addition of inotropes/vasopressors · 72 h
P = 0.07
LV assist device
P = 0.02
VA-ECMO escalation, 30-day mortality, renal replacement therapy, heart transplantation
- No overall significant differences
Original publication
Haemodynamic Effects of Intra-Aortic Balloon Pumps Stratified by Baseline Pulmonary Artery Pulsatility Index. ESC Heart Fail. Published 18 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it