Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series

<p dir="ltr">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 se...

Full description

Saved in:
Bibliographic Details
Main Author: Alaa Rahhal (14150403) (author)
Other Authors: Amr Salah Omar (17151028) (author), Amer Aljundi (14777797) (author), Mohamed Kasem (8602740) (author), Ahmed Mahfouz (737928) (author), Sumaya Alyafei (14147868) (author)
Published: 2022
Subjects:
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1864513553272143872
author Alaa Rahhal (14150403)
author2 Amr Salah Omar (17151028)
Amer Aljundi (14777797)
Mohamed Kasem (8602740)
Ahmed Mahfouz (737928)
Sumaya Alyafei (14147868)
author2_role author
author
author
author
author
author_facet Alaa Rahhal (14150403)
Amr Salah Omar (17151028)
Amer Aljundi (14777797)
Mohamed Kasem (8602740)
Ahmed Mahfouz (737928)
Sumaya Alyafei (14147868)
author_role author
dc.creator.none.fl_str_mv Alaa Rahhal (14150403)
Amr Salah Omar (17151028)
Amer Aljundi (14777797)
Mohamed Kasem (8602740)
Ahmed Mahfouz (737928)
Sumaya Alyafei (14147868)
dc.date.none.fl_str_mv 2022-11-01T00:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.cpcardiol.2021.101071
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Successful_Use_of_Intravenous_B-blocker_Therapy_in_Cardiogenic_Shock_Supported_With_Venoarterial_Extracorporeal_Membrane_Oxygenation_A_Case_Series/24314290
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Intravenous B-blocker Therapy
Cardiogenic Shock
Venoarterial Extracorporeal
Oxygenation
dc.title.none.fl_str_mv Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2021.101071" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2021.101071</a></p>
eu_rights_str_mv openAccess
id Manara2_8a2a8f6c6f74a0d56309029a4129eb15
identifier_str_mv 10.1016/j.cpcardiol.2021.101071
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/24314290
publishDate 2022
repository.mail.fl_str_mv
repository.name.fl_str_mv
repository_id_str
rights_invalid_str_mv CC BY 4.0
spelling Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case SeriesAlaa Rahhal (14150403)Amr Salah Omar (17151028)Amer Aljundi (14777797)Mohamed Kasem (8602740)Ahmed Mahfouz (737928)Sumaya Alyafei (14147868)Biomedical and clinical sciencesCardiovascular medicine and haematologyIntravenous B-blocker TherapyCardiogenic ShockVenoarterial ExtracorporealOxygenation<p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2021.101071" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2021.101071</a></p>2022-11-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.cpcardiol.2021.101071https://figshare.com/articles/journal_contribution/Successful_Use_of_Intravenous_B-blocker_Therapy_in_Cardiogenic_Shock_Supported_With_Venoarterial_Extracorporeal_Membrane_Oxygenation_A_Case_Series/24314290CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/243142902022-11-01T00:00:00Z
spellingShingle Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
Alaa Rahhal (14150403)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Intravenous B-blocker Therapy
Cardiogenic Shock
Venoarterial Extracorporeal
Oxygenation
status_str publishedVersion
title Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
title_full Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
title_fullStr Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
title_full_unstemmed Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
title_short Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
title_sort Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Intravenous B-blocker Therapy
Cardiogenic Shock
Venoarterial Extracorporeal
Oxygenation