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主动脉内反搏的临床及血流动力学结果(作者译)

[Clinical and haemodynamic results with intra-aortic counterpulsation (author's transl)].

作者信息

Grube E, Hoffman J F, Botticelli J T

出版信息

Dtsch Med Wochenschr. 1975 Sep 26;100(39):1968-73. doi: 10.1055/s-0028-1106486.

Abstract

The AVCO balloon pump (model 7) was used on 13 patients with cardiogenic shock and for circulatory support after open-heart surgery. Twelve patients survived, but one patient died of a cerebral embolism which had occurred before the use of the balloon pump. Mean systemic arterial pressure, mean pulmonary artery pressure, pulmonary wedge pressure and heart rate were measured in all patients, while cardiac index and arterio-venous oxygen difference were measured in seven. Average duration of counterpulsation was four days. Vasopressor treatment was reduced or discontinued in all patients, urinary output increased markedly and the clinical state improved. Although systolic pressure did not change significantly, MAP increased significantly by 25 mm Hg (P less than 0.005), with a mean diastolic pressure increase to 104 mm Hg. The pulmonary artery pressure, the pulmonary wedge pressure and the mean pulse rate all decreased significantly by 25 mm Hg, 16 mm Hg and 24 beats/min, respectively. A fall in arterio-venous oxygen difference of 2.6 ml/100 ml (P less than 0.025) was associated with a significant increase in cardiac index by 0.62 l/min-m2 (P less than 0.025). It is concluded from these results that intra-aortic balloon counter-pulsation may be an effective means of providing circulatory support in cardiogenic shock and after open-heart surgery.

摘要

AVCO球囊泵(7型)用于13例心源性休克患者及心脏直视手术后的循环支持。12例患者存活,但1例患者死于在使用球囊泵之前发生的脑栓塞。测量了所有患者的平均体动脉压、平均肺动脉压、肺楔压和心率,7例患者测量了心脏指数和动静脉氧差。平均反搏持续时间为4天。所有患者的血管升压药治疗均减少或停用,尿量显著增加,临床状态改善。虽然收缩压无显著变化,但平均动脉压显著升高25 mmHg(P<0.005),平均舒张压升至104 mmHg。肺动脉压、肺楔压和平均脉率分别显著下降25 mmHg、16 mmHg和24次/分钟。动静脉氧差下降2.6 ml/100 ml(P<0.025),同时心脏指数显著增加0.62 l/min-m2(P<0.025)。从这些结果得出结论,主动脉内球囊反搏可能是在心源性休克和心脏直视手术后提供循环支持的有效手段。

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