Zhang Jingchao, Lang Yan, Guo Longhui, Song Xiaodong, Shu Liliang, Su Gang, Liu Hai, Xu Jing
Department of Cardiac Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland).
Med Sci Monit. 2015 Mar 23;21:855-60. doi: 10.12659/MSM.893021.
Coronary artery bypass grafting (CABG) is an important therapeutic measure for CHD patients. The patients who score more than 12 EuroSCORE points cannot achieve good results because of their low cardiac output and delicate left ventricular function. Therefore, use of an intra-aortic balloon pump (IABP) is essential for coronary surgical patients in the peri-operative period. At present, there is no unified standard about when to insert an IABP. This study aimed to compare the short-term clinical outcomes of the IABP inserted in the preoperative condition with its use in the emergency condition for extremely high-risk patients.
IABP support time, respirator support time, and ICU stay time were significantly shorter (all p<0.05) in the preoperative IABP group compared to the emergency IABP group, and the rates of low cardiac output syndrome (LCOS), acute myocardial infarction, and acute kidney injury in the preoperative group were also significantly lower in the preoperative IABP group (all p<0.05). There were no significant differences in IABP-related complications and the mortality (p=0.106) between two groups.
Compared to the emergency IABP group, the IABP support time, respirator support time and ICU stay time were significantly lower in the preoperative IABP group (all p<0.05), and the rates of LCOS, acute myocardial infarction, and acute kidney injury in the preoperative group were also significantly lower (all p<0.05). There were no significant differences in IABP-related complications and the mortality (p=0.106) between the 2 groups.
For high-risk patients with CABG, preoperative IABP insertion is a safe and effective measure.
冠状动脉旁路移植术（CABG）是冠心病患者的重要治疗手段。欧洲心脏手术风险评估系统（EuroSCORE）评分超过12分的患者，由于心输出量低和左心室功能脆弱，无法取得良好疗效。因此，对于冠状动脉手术患者围手术期而言，使用主动脉内球囊反搏（IABP）至关重要。目前，关于何时插入IABP尚无统一标准。本研究旨在比较极高危患者术前插入IABP与急诊情况下使用IABP的短期临床疗效。
与急诊IABP组相比，术前IABP组的IABP支持时间、呼吸机支持时间和重症监护病房（ICU）停留时间显著缩短（均p<0.05），术前组的低心输出量综合征（LCOS）、急性心肌梗死和急性肾损伤发生率也显著降低（均p<0.05）。两组之间IABP相关并发症和死亡率无显著差异（p=0.106）。
与急诊IABP组相比，术前IABP组的IABP支持时间、呼吸机支持时间和ICU停留时间显著缩短（均p<0.05），术前组的LCOS、急性心肌梗死和急性肾损伤发生率也显著降低（均p<0.05）。两组之间IABP相关并发症和死亡率无显著差异（p=0.106）。
对于行CABG的高危患者，术前插入IABP是一种安全有效的措施。
