Mirmohammadsadeghi Amir, Afzali Arani Moniresadat, Zavar Reihaneh
Department of Cardiovascular Surgery, Chamran Cardiovascular and Medical Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2022 Jul;18(4):1-4. doi: 10.48305/arya.v18i0.2448.
Some patients require intra-aortic balloon pump (IABP) after coronary artery bypass graft (CABG) surgery. IABP can be adjusted to different frequencies such as 1:1, 1:2, or 1:3. In this study, we tried to compare the effect of 1:1 and 1:2 frequencies of IABP on hemodynamic status of the patients after CABG surgery.
In this experimental study, all patients using IABP after CABG surgery were entered the study as pretest and posttest groups. The study could not be blinded because of the clearness of posttest group for the same echocardiographist. The pretest group included patients using a 1:1 frequency of IABP device. The posttest group included patients in the pretest group who were exposed to a 1:2 frequency for 20 minutes. In both groups, on the moderate dose of inotropic support, hemodynamic parameters of patients including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI), stroke volume (SV), and velocity time integral (VTI) in the aorta during systole were measured. Both groups were compared using Wilcoxon signed rank test. SPSS software was used for analysis and P < 0.05 was considered to be statistically significant.
Twelve patients were entered into the study. Three patients were excluded because of open chest and instability of vital signs. Nine patients completed the study. 3 patients were men and 6 were women. The mean age was 58.32 ± 13.18 years. MAP in 1:1 frequency was significantly higher than 1:2 (P = 0.043); however, there was no significant difference between 1:1 and 1:2 in other hemodynamic parameters, namely CO, CI, SV, HR, and VTI.
In patients on moderate dose of inotropes, IABP frequencies of 1:1 and 1:2 have the same effect on hemodynamic parameters such as CI, SBP, DBP, HR, and left ventricular outflow tract (LVOT) VTI; meanwhile, MAP remains higher in 1:1 frequency.
一些患者在冠状动脉旁路移植术（CABG）后需要主动脉内球囊反搏（IABP）。IABP可调整为不同频率，如1:1、1:2或1:3。在本研究中，我们试图比较IABP的1:1和1:2频率对CABG术后患者血流动力学状态的影响。
在本实验研究中，所有CABG术后使用IABP的患者作为预测试组和后测试组纳入研究。由于后测试组对同一位超声心动图医生来说情况明确，该研究无法设盲。预测试组包括使用IABP装置1:1频率的患者。后测试组包括预测试组中接受1:2频率20分钟的患者。两组均在中等剂量的正性肌力支持下，测量患者的血流动力学参数，包括收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）、心输出量（CO）、心脏指数（CI）、每搏输出量（SV）以及收缩期主动脉内的速度时间积分（VTI）。两组使用Wilcoxon符号秩检验进行比较。采用SPSS软件进行分析，P < 0.05被认为具有统计学意义。
12名患者纳入研究。3名患者因开胸和生命体征不稳定被排除。9名患者完成研究。3名男性，6名女性。平均年龄为58.32±13.18岁。1:1频率时的MAP显著高于1:2频率（P = 0.043）；然而，1:1和1:2在其他血流动力学参数，即CO、CI、SV、HR和VTI方面无显著差异。
在中等剂量正性肌力药物治疗的患者中，IABP的1:1和1:2频率对CI、SBP、DBP、HR和左心室流出道（LVOT）VTI等血流动力学参数具有相同影响；同时，1:1频率时的MAP仍然较高。
