Pulsatile Cardiopulmonary Bypass With Intra-Aortic Balloon Pump Improves Organ Function and Reduces Endothelial Activation

DOI Web Site PubMed 被引用文献2件 参考文献45件
  • Serraino Giuseppe Filiberto
    Department of Clinical and Experimental Medicine, Cardiac Surgery Unit, University of Magna Graecia Department of Clinical and Experimental Medicine, Cardiac Surgery Unit, University of Magna Graecia
  • Marsico Roberto
    Department of Clinical and Experimental Medicine, Cardiac Surgery Unit, University of Magna Graecia Department of Clinical and Experimental Medicine, Cardiac Surgery Unit, University of Magna Graecia
  • Musolino Giuseppe
    Department of Clinical and Experimental Medicine, Cardiac Surgery Unit, University of Magna Graecia Department of Clinical and Experimental Medicine, Cardiac Surgery Unit, University of Magna Graecia
  • Ventura Valeria
    Department of Clinical and Experimental Medicine, Clinical Pathology Unit, University of Magna Graecia Department of Clinical and Experimental Medicine, Clinical Pathology Unit, University of Magna Graecia
  • Gulletta Elio
    Department of Clinical and Experimental Medicine, Clinical Pathology Unit, University of Magna Graecia Department of Clinical and Experimental Medicine, Clinical Pathology Unit, University of Magna Graecia
  • Santè Pasquale
    Department of Cardiothoracic and Respiratory Sciences, AON Monaldi Second University of Naples Department of Cardiothoracic and Respiratory Sciences, AON Monaldi Second University of Naples
  • Renzulli Attilio
    Department of Clinical and Experimental Medicine, Cardiac Surgery Unit, University of Magna Graecia Department of Clinical and Experimental Medicine, Cardiac Surgery Unit, University of Magna Graecia

書誌事項

公開日
2012
資源種別
journal article
DOI
  • 10.1253/circj.cj-11-1027
公開者
一般社団法人 日本循環器学会

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説明

Background: We aimed to evaluate if the use of an intra-aortic balloon pump (IABP) during cardioplegic arrest improves organ function and reduces endothelial activation in patients undergoing coronary artery bypass graft (CABG). Methods and Results: Five-hundred and one CABG patients were randomized into 2 groups: (Group A n=270) linear cardiopulmonary bypass (CPB); and (Group B n=231) automatic 80beats/min IABP-induced pulsatile CPB. We evaluated hemodynamic response, coagulation and fibrinolysis, transaminase, bilirubin, amylase, lactate, renal function (estimated glomerular filtration rate [eGFR], creatinine and any possibility of renal insufficiency or failure), respiratory function and endothelial markers (vascular endothelial growth factor [VEGF] and monocyte chemotactic protein-1 [MCP-1]). IABP, which induced surplus hemodynamic energy, was 21,387±4,262ergs/cm3. Group B showed lower chest drainage, transfusions, international normalized ratio, and antithrombin III, together with higher platelets, activated partial thromboplastin time, fibrinogen and D-dimer. Transaminases, bilirubin, amylase, lactate were lower in Group B; there were better results for eGFR in Group B from ICU-arrival to 48h, resulting in lower creatinine from ICU-arrival to 48h. The necessity for renal replacement therapy was lower in Group B Stage-3. Group B PaO2/FiO2 and lung compliance improved with aortic de-clamping on the first day with shorter intubation time. Group B showed lower VEGF and MCP-1. Conclusions: Pulsatile flow by IABP improves whole-body perfusion and reduces endothelial activation during CPB. (Circ J 2012; 76: 1121-1129)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 76 (5), 1121-1129, 2012

    一般社団法人 日本循環器学会

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