In severe cases, placement of an intra-aortic balloon counter pulsation device or extracorporeal membrane oxygenation [ 23] may be necessary.
Forty-two items were scored, including patient demographics; diagnosis; SOFA score pretransportation and post-transportation; use of vasoactive medications; ventilator settings; transport-related factors such as transport time, transport team members; additional medical devices such as extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon counter pulsation (IABP); and critical events.
Intra-aortic balloon counter-pulsation (IABP) is standard of care in treatment of cardiogenic shock.
13 Necessary equipment should also be considered, including a transportable intra-aortic balloon counter-pulsation pump (IABP).
Agents considered to be primarily vasopressors (e.g. norepinephrine, arginine vasopressin and phenylephrine) and mechanical support (e.g. intra-aortic balloon counter-pulsation and assist devices) are not considered.
Availability of intra-aortic balloon counter-pulsation pump (IABP), IVUS, rotational atherectomy, and pressure wire systems are mandatory for left main intervention procedures along with the necessary expertise.
Full resuscitation facilities including a defibrillator, intra-aortic balloon counter-pulsation and an anaesthetic machine should be readily available in all catheterisation laboratories undertaking PCI.
Such LCOS can persist for several hours to days, despite optimization of volume status, temporary pacing, or exclusion of mechanical factors (e.g. cardiac tamponade and mechanical assistance with intra-aortic balloon counter-pulsation).
The goals suggested by Pfisterer [ 20] for right ventricular infarction are as follows: early recognition, early reperfusion, maintenance of adequate preload, reduction in right ventricular afterload (inotropes, balloon counter-pulsation), preservation of right ventricular synchrony and avoidance of vasodilators, nitrates, morphine and β-blockers.
All patients required intravenous inotropic support, 19 patients (21%) were treated with an intraaortic balloon counter-pulsation and nine patients (9%) were on extracorporeal circulatory support (eight patients (8%) had an extracorporeal membrane oxygenation, one patient (1%) was on novacor support).
Urgent angiography, percutaneous cardiac intervention and, if necessary, circulatory support using intraaortic balloon pump counter pulsations was undertaken when indicated.
