Possibility of an Intra-Aortic Balloon Pump as a Bridge Therapy to Recovery for Septic Cardiomyopathy

Original Article
Introduction: Myocardial damage is reported in about 20% to 60% of sepsis cases. The circulatory system in early sepsis is hyperdynamic in state, but with time, cardiac function decreases and shifts toward cardiogenic shock. This study aimed to determine whether an intra-aortic balloon pump (IABP) could be an effective cardiac support for septic cardiomyopathy. Methods: Twelve patients with septic cardiomyopathy who were screened between April 2010 and March 2016 in the Saiseikai Yokohamashi Tobu Hospital Emergency and Critical Care Center were enrolled retrospectively for this observational study. Hemodynamics was evaluated using the following parameters: mean blood pressure; heart rate; catecholamine index; and serum lactate level. These parameters were compared before IABP insertion and at 24 and 72 hours after insertion. Cardiac function was assessed by evaluating the N-terminal pro b-type natriuretic peptide (NT-pro BNP) and left ventricular ejection fraction (LVEF) at days 0, 3, and 7 after intensive care unit admission. Results: The mean blood pressure tended to increase, the heart rate significantly decreased, and the catecholamine index and serum lactate levels decreased significantly after IABP insertion. Nine of the 12 patients survived and showed improved LVEF, which returned to the normal range during the follow-up period. Conclusions: From our experience of 12 cases, we suggest that IABP may be used for septic cardiomyopathy.