Limet R, Maille J G, Lepage G
Arch Mal Coeur Vaiss. 1976 May;69(5):495-502.
Use of the intra-aortic balloon in the treatment of circulatory failure after cardiac surgery has resulted in the long-term survival of 7 patients out of 20. The failures occured when the myocardium is severely compromised so that any treatment is likely to fait (8/13), and where there is the ultimate complication of renal or hepatic failure (4/13), irreversible ventricular failure or secondary haemorrhage. In urgent coronary bypass surgery (4/13) it would appear that the use of the balloon preoperatively would have avoided or at least slowed the progress toward the anatomical changes of massive infarction. As the use of the balloon has often been associated with a reduction in the number of circulating platelets and a pathological increase in the breakdow products of fibrin, heparin is now used systematically in an attempt to prevent the development of a true intravascular coagulation syndrome. The use of lidocaine is also recommended to prevent fatal or dangerous ventricular arrhythmias when the balloon is functioning well. A combination of the intra-aortic balloon with the infusion of small doses of adrenaline would seem to be an interesting therapeutic combination, especially at the onset of counterpressure.
主动脉内球囊用于心脏手术后循环衰竭的治疗，使20例患者中的7例长期存活。治疗失败发生在心肌严重受损以至于任何治疗都可能失败的情况下（13例中有8例），以及存在肾或肝功能衰竭这一最终并发症的情况下（13例中有4例）、不可逆性心力衰竭或继发性出血。在急诊冠状动脉搭桥手术中（13例中有4例），术前使用球囊似乎本可避免或至少减缓向大面积梗死的解剖学改变发展的进程。由于球囊的使用常常与循环血小板数量减少以及纤维蛋白降解产物病理性增加有关，目前系统性地使用肝素以试图预防真正的血管内凝血综合征的发生。当球囊功能良好时，也推荐使用利多卡因以预防致命或危险的室性心律失常。主动脉内球囊与小剂量肾上腺素输注相结合似乎是一种有意思的治疗组合，尤其是在反搏开始时。
