Parissis Haralambos, Leotsinidis Michael, Dougenis Dimitrios, Richens David
Cardiothoracic Department, St James Hospital, D8, Dublin, Ireland.
Interact Cardiovasc Thorac Surg. 2007 Aug;6(4):425-9. doi: 10.1510/icvts.2006.147256. Epub 2007 Apr 18.
This study set off to investigate which mode of weaning of an intra-aortic balloon pump (IABP) produces more aortic trauma. With the use of a perfusion pump, an intact porcine aorta with an IABP in situ, was studied. Angioscopic images of the interior of the aorta were obtained. Whilst keeping steady blood pressure and flow, an 'aortic impact score' was calculated. Endoscopically there is a 'whipping' effect of the balloon shaft on the lateral aortic wall, which appears to be prominent in 1:3 mode. The aortic impact score at 0.5, 6 and 12 h during the experiments was: (1) When weaning by mode: a) 1:1 3.3+/-0.6, 4.0+/-1.0 and 4.3+/-0.6; b) 1:2 4.7+/-0.6, 6.7+/-0.6 and 7.0+/-0.0; c) 1:3 8.7+/-0.6, 11+/-1.0 and 11.7+/-0.6. (2) Weaning by augmentation: a) 75% 2.3+/-0.6, 2.7+/-0.6 and 3.0+/-0.0; b) 50% 1.3+/-0.6, 1.3+/-0.6 and 1.7+/-0.6. An increasing score was observed while weaning by mode (P<0.05). The 1:3 mode produces marked intimal disruption that worsens with time.
本研究旨在探究主动脉内球囊反搏（IABP）的哪种撤机模式会导致更多的主动脉损伤。利用灌注泵，对植入IABP的完整猪主动脉进行了研究。获取了主动脉内部的血管内镜图像。在保持血压和血流稳定的同时，计算了“主动脉冲击评分”。在内镜下，球囊导管对主动脉侧壁有“鞭打”效应，在1:3模式下这种效应似乎很明显。实验过程中0.5、6和12小时的主动脉冲击评分如下：（1）按模式撤机时：a）1:1模式分别为3.3±0.6、4.0±1.0和4.3±0.6；b）1:2模式分别为4.7±0.6、6.7±0.6和7.0±0.0；c）1:3模式分别为8.7±0.6、11±1.0和11.7±0.6。（2）按减搏量撤机时：a）75%减搏量分别为2.3±0.6、2.7±0.6和3.0±0.0；b）50%减搏量分别为1.3±0.6、1.3±0.6和1.7±0.6。按模式撤机时观察到评分增加（P<0.05）。1:3模式会导致明显的内膜破坏，且随着时间推移会加重。
