心肌挫伤：主动脉内球囊反搏对心输出量的影响。

Myocardial contusion: effect of intra-aortic balloon counterpulsation on cardiac output.

作者信息

Saunders C R, Doty D B

出版信息

J Trauma. 1978 Oct;18(10):706-8.

Abstract

Intra-aortic balloon counterpulsation (IABCP) improves impaired left ventricular (LV) performance associated with myocardial ischemia. We have evaluated the effect of IABCP on cardiac output (CO) after blunt trauma to the heart where LV performance is impaired by myocardial contusion but coronary blood flow is normal. Contusion of 20 to 40% of the LV in 13 dogs decreased CO by 41% +/- 6.4. A 30-minute period of IABCP was followed by 30 minutes without IABCP with three assist periods in each animal unless death occurred. Immediate IABCP after injury in six dogs increased CO 14% +/- 3.8 (p less than 0.01). Treatment was delayed for 30 minutes in seven dogs, and CO further decreased 0.7% +/- 3.2; initiation of IABCP then increased CO 9.2% +/- 6.5 (p less than 0.05). When CO was decreased less than 25% or greater than 50% after injury, IABCP had no effect on CO. In midrange when CO decreased 25 to 50%, IABCP increased CO 12.5% +/- 3.2 (p less than 0.001 initially, 9.3% +/- 1.3 (p less than 0.005) with second assist, and third assist 5.6% +/- 2(NS). It is concluded that IABCP improves LV performance following myocardial contusion, especially when applied early after injury.

摘要

主动脉内球囊反搏（IABCP）可改善与心肌缺血相关的左心室（LV）功能受损。我们评估了IABCP对心脏钝性创伤后心输出量（CO）的影响，在这种情况下，左心室功能因心肌挫伤而受损，但冠状动脉血流正常。13只狗左心室20%至40%的挫伤使心输出量降低了41%±6.4。每只动物进行30分钟的IABCP，随后30分钟不进行IABCP，每个动物进行三个辅助周期，除非死亡发生。六只狗受伤后立即进行IABCP，心输出量增加了14%±3.8（p<0.01）。七只狗的治疗延迟30分钟，心输出量进一步降低0.7%±3.2；然后开始IABCP，心输出量增加9.2%±6.5（p<0.05）。当受伤后心输出量降低小于25%或大于50%时，IABCP对心输出量没有影响。在心输出量降低25%至50%的中等范围内，IABCP最初使心输出量增加12.5%±3.2（p<0.001），第二次辅助时增加9.3%±1.3（p<0.005），第三次辅助时增加5.6%±2（无统计学意义）。结论是，IABCP可改善心肌挫伤后的左心室功能，尤其是在受伤后早期应用时。