Reply to opinions about intraaortic balloon pumping under venoarterial extracorporeal membrane oxygenation
Authors reply to “IABP plus ECMO—is one and one more than two?”
We thank Nuding and Werdan for their interest in our study. We respectfully disagree with their comment that it is unknown if IABP combined with VA-ECMO improves macro- and microcirculation more than VA-ECMO alone. Recent studies showed that IABP combined with VA-ECMO improved macro- and microcirculation, compared with VA-ECMO alone (1-3). According to our results and recent studies, IABP combined with VA-ECMO was theoretically and clinically more effective than VA-ECMO alone. We agree with Nuding and Werdan’s comment that randomized control trial with the endpoint “survival” is required to evaluate the effect of IABP combined with VA-ECMO. This may be true, and we hope they will do it themselves.
Authors reply to “IABP during VA ECMO: multi-device mechanical circulatory support approach for acute cardiogenic shock”
We thank Scandroglio and colleagues for their interest in our study. We agree with Scandroglio and colleagues’ comment that the role of IABP for patients treated with ECLS in the setting of cardiac arrest should be further evaluated. Patients receiving out-of-hospital cardiopulmonary resuscitation were excluded in our study in order to measure the effect of IABP accurately. We also agree that further cardiac life-supporting devices that reduce preload should be developed.
Acknowledgements
None.
Footnote
Conflicts of Interest: The authors have no conflicts of interest to declare.
References
- Petroni T, Harrois A, Amour J, et al. Intra-aortic balloon pump effects on macrocirculation and microcirculation in cardiogenic shock patients supported by venoarterial extracorporeal membrane oxygenation. Crit Care Med 2014;42:2075-82. [Crossref] [PubMed]
- Madershahian N, Liakopoulos OJ, Wippermann J, et al. The impact of intraaortic balloon counterpulsation on bypass graft flow in patients with peripheral ECMO. J Card Surg 2009;24:265-8. [Crossref] [PubMed]
- Ma P, Zhang Z, Song T, et al. Combining ECMO with IABP for the treatment of critically ill adult heart failure patients. Heart Lung Circ 2014;23:363-8. [Crossref] [PubMed]
