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Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
- Source :
- Current problems in cardiology. 47(11)
- Publication Year :
- 2021
-
Abstract
- Tachycardia in cardiogenic shock (CS) might reduce the cardiac output (CO) by decreasing the ventricular filling time. Nevertheless, heart rate (HR) control with agents that possess negative inotropy might decrease the CO. Therefore, controlling the tachycardia in the setting of CS remains controversial. We herein describe four cases of patients presenting with myocardial infarction complicated with CS that required rescue venoarterial extracorporeal membrane oxygenation (VA-ECMO) initiation. Tachycardia was present with HR ∼130-140 beats per minute after VA-ECMO initiation, and hence esmolol was infused continuously at a starting dose of 10-20 mcg/kg/min and titrated according to HR. With the use of esmolol to control the HR in the setting of CS supported with VA-ECMO, lactate cleared, and echocardiographic parameters improved, allowing the four cases to be successfully decannulated from ECMO. Our report indicates that short-acting beta-blocker could be safely used in the complex scenario of severe tachycardia while supported with VA-ECMO.
- Subjects :
- Tachycardia
Cardiac output
medicine.medical_specialty
medicine.drug_class
medicine.medical_treatment
Myocardial Infarction
Shock, Cardiogenic
Propanolamines
Extracorporeal Membrane Oxygenation
Internal medicine
Heart rate
Extracorporeal membrane oxygenation
Medicine
Humans
Myocardial infarction
Beta blocker
business.industry
Cardiogenic shock
General Medicine
medicine.disease
Esmolol
surgical procedures, operative
Cardiology
Lactates
medicine.symptom
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 15356280
- Volume :
- 47
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Current problems in cardiology
- Accession number :
- edsair.doi.dedup.....56929c4b2824e46652d6b5520c0067e4