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• W2187127923 abstract "El balón de contrapulsación intraaórtico es el dispositivo de soporte ventricular más utilizado en los últimos 40 años. Sus principales indicaciones son el shock cardiogénico, el infarto agudo de miocardio y asistencia al intervencionismo coronario percutáneo de alto riesgo. La evidencia científica que respalda dicha práctica es escasa. Estudios previos habían indicado que el beneficio de la contrapulsación intraaórtica en el shock se limitaba a los pacientes no reperfundidos o a los sometidos a fibrinolisis, mientras que en los pacientes sometidos a intervencionismo coronario percutáneo primario, tanto sus beneficios hemodinámicos como su impacto clínico parecían atenuarse. Recientemente, los datos del ensayo IABP-shock-II han modificado sensiblemente la recomendación del balón de contrapulsación para pacientes con shock , y se desaconseja su utilización sistemática en este escenario. En este artículo se revisa la principal evidencia sobre el uso del balón de contrapulsación en sus diferentes indicaciones. La amplia experiencia sobre el beneficio clínico y hemodinámico en numerosos pacientes en la práctica clínica cotidiana hace especialmente importante progresar en la definición del escenario idóneo para su utilización; son situaciones potencialmente favorables el paciente con deterioro hemodinámico en sus fases más incipientes o el paciente inestable con lesiones coronarias residuales en los que se planea una revascularización en segundo tiempo. The intra-aortic balloon pump has been the most commonly used ventricular assist device for the last 40 years. Its main indications are cardiogenic shock, acute myocardial infarction and the support of patients undergoing high-risk percutaneous coronary interventions. However, scientific evidence supporting this practice is scarce. Previous studies suggest that the benefits of the intra-aortic balloon pump in patients with cardiogenic shock is limited to patients who have not undergone reperfusion and to those who have received thrombolysis, whereas, in those undergoing primary percutaneous coronary interventions, both the hemodynamic and clinical benefits appear to be small. Recently, the findings of the IABP–SHOCK II trial have markedly changed recommendations on the use of the intra-aortic balloon pump in patients with shock, and its routine use in this context is now discouraged. This article contains a review of the main evidence available on the use of the intra-aortic balloon pump for its different indications. Broad experience of the clinical and hemodynamic benefits of the technique in a large number of patients in routine clinical practice is particularly important for determining where best it can be used: patients in the early stages of hemodynamic deterioration and those with unstable, residual coronary lesions scheduled for a second revascularization could be particularly promising candidates." @default.
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• W2187127923 date "2015-01-01" @default.
• W2187127923 modified "2023-09-24" @default.
• W2187127923 title "Balón de contrapulsación: ¿ha llegado el momento de su jubilación?" @default.
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• W2187127923 doi "https://doi.org/10.1016/s1131-3587(15)30030-3" @default.
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