Gelsomino Sandro, Lozekoot Pieter W J, de Jong Monique M J, Lucà Fabiana, Parise Orlando, Matteucci Francesco, Romano Mario, Hossien Abdullrazak, La Meir Mark, Marchionni Niccolò, Maessen Jos G, Lorusso Roberto
1 Maastricht University Medical Center, Maastricht, The Netherlands.
2 Department of Cardiothoracic and Vascular Medicine, Careggi Hospital and University of Florence, Italy.
Perfusion. 2017 May;32(4):285-295. doi: 10.1177/0267659116678058. Epub 2016 Nov 19.
We evaluated the influence of intra-aortic balloon size and volume on mesenteric and renal flows.
Thirty healthy swine underwent 120-minute ligation of the left anterior descending coronary artery followed by 6 hours of reperfusion. Then, they were randomly assigned to the following five groups of animals, with six animals in each group: no intra-aortic balloon pump (IABP), a short 35-mL IABP, a short 40-mL IABP, a long 35-mL IABP and a long 40-mL IABP. Superior mesenteric artery (SMA) and renal flows were measured at baseline (t), at 2-hour ischemia (t) and every hour thereafter until 6 hours of reperfusion (from t to t).
SMA flows increased significantly at t only in the two short IABP groups (p<0.001) and balloon volume did not appear to affect flows which, at any experimental time-point, were comparable using 35 mL or 40 mL balloons (p>0.05). Renal flows appeared to be influenced by balloon length, but not by volume. Indeed, flows in the renal arteries rose during IABP treatment; the increase was significantly higher in the short balloon groups and throughout the whole reperfusion (all, p<0.001).
Changes in visceral perfusion during IABP assistance were significantly related to balloon length, but not to its volume. This could be relevant for the evolution of balloon engineering design in order to reduce the incidence of mesenteric ischemia following IABP. Further research is necessary to confirm these findings.
我们评估了主动脉内球囊大小和容积对肠系膜血流和肾血流的影响。
30只健康猪先进行120分钟的左前降支冠状动脉结扎，随后进行6小时的再灌注。然后，将它们随机分为以下五组动物，每组6只：未使用主动脉内球囊泵（IABP）、短35 mL IABP、短40 mL IABP、长35 mL IABP和长40 mL IABP。在基线时（t）、缺血2小时时（t）以及此后每小时直至再灌注6小时（从t到t）测量肠系膜上动脉（SMA）和肾血流。
仅在两个短IABP组中，SMA血流在t时显著增加（p<0.001），球囊容积似乎不影响血流，在任何实验时间点，使用35 mL或40 mL球囊时血流相当（p>0.05）。肾血流似乎受球囊长度影响，但不受容积影响。实际上，在IABP治疗期间肾动脉血流增加；短球囊组的增加更为显著，且在整个再灌注期间均如此（所有p<0.001）。
IABP辅助期间内脏灌注的变化与球囊长度显著相关，而与球囊容积无关。这可能与球囊工程设计的改进相关，以降低IABP后肠系膜缺血的发生率。需要进一步研究来证实这些发现。
