Gelsomino Sandro, Lozekoot Pieter Willem, Lorusso Roberto, de Jong Monique Maria, Parise Orlando, Matteucci Francesco, Lucà Fabiana, Kumar Narendra, Dehkord Eshan Sadeghian, Romano Salvatore Mario, Gensini Gian Franco, La Meir Mark, Maessen Josephus Gregorius
From the *Maastricht University Medical Center, Maastricht, the Netherlands; †Careggi Hospital, Florence, Italy; and ‡Department of Cardiothoracic Surgery, University Hospital, Brussels, Belgium.
Innovations (Phila). 2016 Jan-Feb;11(1):46-53; discussion 53. doi: 10.1097/IMI.0000000000000233.
Visceral ischemia can be a potentially life-threatening complication of intra-aortic balloon pump (IABP) support. A shorter IABP catheter might lead to a reduction of visceral complications. In this animal study, we evaluate the effects of a 35-mL short catheter in comparison with a 40-mL standard-sized catheter.
Eighteen healthy swine underwent 120-minute ligation of the left anterior descending coronary artery followed by 6 hours of reperfusion being supported by either a short IABP catheter (short group) (n = 6) or a long IABP catheter (long group) (n = 6) or with no assistance (controls) (n = 6). Hemodynamics, visceral and coronary flows, as well as biochemical markers were evaluated throughout the different phases of the protocol.
Mesenteric flows increased significantly at reperfusion (P < 0.001 both) remaining constant afterward (all, P > 0.05) in the short group, while remaining significantly lower in the long group at the start of reperfusion, remaining constantly lower than the short group and controls (P < 0.001 vs short, P < 0.003 vs controls). In both long and short groups, catheters improved renal flows at reperfusion (P < 0.001 both) without any further variation (P > 0.05). In the short group, the flows were higher during the whole of reperfusion (all, P < 0.05). Intra-aortic balloon pump support improved hemodynamic indices and coronary blood flows during reperfusion to a similar extent in both the small and the long group (P > 0.05).
The short IABP catheter proved to be as effective as the standard-sized catheter in supporting hemodynamics and coronary circulation. Furthermore, it even improves visceral flows in comparison with conventional IABP catheters.
内脏缺血可能是主动脉内球囊反搏（IABP）支持治疗的一种潜在威胁生命的并发症。较短的IABP导管可能会减少内脏并发症。在本动物研究中，我们评估了35 mL短导管与40 mL标准尺寸导管相比的效果。
18只健康猪接受120分钟的左前降支冠状动脉结扎，随后在短IABP导管（短组）（n = 6）或长IABP导管（长组）（n = 6）支持下再灌注6小时，或不给予辅助（对照组）（n = 6）。在方案的不同阶段评估血流动力学、内脏和冠状动脉血流以及生化标志物。
短组再灌注时肠系膜血流显著增加（两者P < 0.001），之后保持恒定（所有P > 0.05），而长组在再灌注开始时显著低于短组，且一直低于短组和对照组（与短组相比P < 0.001，与对照组相比P < 0.003）。在长组和短组中，导管在再灌注时均改善了肾血流（两者P < 0.001），且无进一步变化（P > 0.05）。短组在整个再灌注期间血流较高（所有P < 0.05）。在再灌注期间，主动脉内球囊反搏支持在小导管组和长导管组中对血流动力学指标和冠状动脉血流的改善程度相似（P > 0.05）。
短IABP导管在支持血流动力学和冠状动脉循环方面与标准尺寸导管同样有效。此外，与传统IABP导管相比，它甚至还改善了内脏血流。
