Acute Coronary Syndrome: IABP-SHOCK II (The Intraaortic Balloon Pump in Cardiogenic Shock II) Flashcards Preview

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Flashcards in Acute Coronary Syndrome: IABP-SHOCK II (The Intraaortic Balloon Pump in Cardiogenic Shock II) Deck (6)
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1
Q

IABP-SHOCK II Clinical Question

A

In patients with acute MI complicated by cardiogenic shock, does an intraaortic balloon pump (IABP) reduce mortality?

2
Q

IABP-SHOCK II Bottom Line

A

In patients with acute MI complicated by cardiogenic shock, there was no difference in 30-day mortality with IABP placement.

3
Q

IABP-SHOCK II Primary End Point

A

30-day mortality

4
Q

IABP-SHOCK II inclusion criteria

A

Acute STEMI or NSTEMI complicated by cardiogenic shock:

  • -SBP <90 mmHg for >30 mins or requiring catecholamines to maintain SBP >90 mmHg
  • -Clinical signs of pulmonary congestion
  • -Impaired end-organ perfusion (i.e. altered mental status, cold, clammy skin and extremities; UOP<30cc/hr; serum lactate >2.0 mmol/L)
5
Q

IABP-SHOCK II criticisms

A
  • LVAD use was not controlled.
  • Timing of IABP insertion was not controlled. 86.6% of IABPs went in post-PCI.
  • Lower mortality rate (40%) in this trial compared to other registries and RCTs (42-48%) suggests more mild or moderately severe shock cases, precluding generalizability to severe shock.
  • Small sample size
  • 10% cross-over rate from control group to IABP
  • Long-term follow-up results to follow
  • High use of catecholamines and relatively low rate of systolic hypotension (many had systolic BP >90 before randomization)
6
Q

What is an intraaortic balloon pump

A

an inflatable device placed in the aorta that inflates with diastole and deflates with systole

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