0077: Use of an intraaortic balloon counter-pulsation as a means of preventing pulmonary edema in patients with laminar flow under peripheral venous-arterial extra-corporeal life support

ExtraCorporeal Life Support (ECLS) restores hemodynamic stability in patients with severe cardiocirculatory failure. However, this circulatory assistance technique has its limits, and the most strongly feared is left ventricular distention, of which the potentially serious consequences range from acute pulmonary edema (APE) to left intraventricular thrombosis. Our hypothesis is that in patients in refractory cardiogenic shock and with laminar flow under peripheral V-A ECLS, IABP use could help to diminish the incidence of acute pulmonary edema (APE).MethodsThe clinical evolution of patients with laminar flow under peripheral V-A ECLS who did not receive IABP (group A) has been compared to the clinical evolution of patients who received IABP as a means of APE prevention under peripheral V-A ECLS, while also being subjected to laminar flow under peripheral V-A ECLS (group B). A logistic regression model was used to identify the factors associated with occurrence of severe and symptomatic APE.ResultsBetween December 2007 and 2012, 90 patients were subjected to laminar flow under peripheral V-A ECLS that had been implanted subsequent to cardiogenic shock. Mortality and mechanical ventilation duration was not significantly different in either of the two groups. However, clinical APE occurrence was far less frequent in group B (35.1% vs. 88.6% p<0.0001). Study of the radiologic score showed that pulmonary infiltrate was greater in group A (p≤0,001). Centralized pulmonary edema was likewise more frequent in group A (44.6% vs. 5.9%, p