BACKGROUND: Over the past decade, the use of a ventricular-assist device (VAD) in patients with postcardiotomy cardiogenic shock has resulted in hospital discharge rates of 25% to 40% and is improving. Nevertheless, indications for and timing of the implantation of a VAD in patients who have received an intra-aortic balloon pump (IABP) remain unclear. METHODS AND RESULTS: From July 1996 to March 2000, 391 patients with cardiac low-output syndrome who underwent open-heart surgery and had an IABP implanted were analyzed in a retrospective pilot study. The perioperative mortality was 34% (133 patients). Clinical parameters were analyzed 1 hour after IABP support began. Statistical multivariate analysis showed that patients with an adrenaline requirement higher than 0.5 microg x kg(-1) x min(-1), a left atrial pressure >15 mm Hg, urine output <100 mL/h, and mixed venous saturation (SVO(2)) <60% had poor outcomes. Using this data, we developed an IABP score (0 to 5 points) to predict survival early after IABP implantation in cardiac surgery. We evaluated our score by monitoring another 101 patients as a control group prospectively. Additionally, 210 patients who received coronary artery bypass grafting (CABG) exclusively were analyzed. All investigations confirmed the validity of the score. CONCLUSIONS: The IABP score can predict survival early after IABP implantation. In patients with a high IABP score, implantation of a VAD should be considered.
BACKGROUND: Over the past decade, the use of a ventricular-assist device (VAD) in patients with postcardiotomy cardiogenic shock has resulted in hospital discharge rates of 25% to 40% and is improving. Nevertheless, indications for and timing of the implantation of a VAD in patients who have received an intra-aortic balloon pump (IABP) remain unclear. METHODS AND RESULTS: From July 1996 to March 2000, 391 patients with cardiac low-output syndrome who underwent open-heart surgery and had an IABP implanted were analyzed in a retrospective pilot study. The perioperative mortality was 34% (133 patients). Clinical parameters were analyzed 1 hour after IABP support began. Statistical multivariate analysis showed that patients with an adrenaline requirement higher than 0.5 microg x kg(-1) x min(-1), a left atrial pressure >15 mm Hg, urine output <100 mL/h, and mixed venous saturation (SVO(2)) <60% had poor outcomes. Using this data, we developed an IABP score (0 to 5 points) to predict survival early after IABP implantation in cardiac surgery. We evaluated our score by monitoring another 101 patients as a control group prospectively. Additionally, 210 patients who received coronary artery bypass grafting (CABG) exclusively were analyzed. All investigations confirmed the validity of the score. CONCLUSIONS: The IABP score can predict survival early after IABP implantation. In patients with a high IABP score, implantation of a VAD should be considered.
Authors: Shinichi Fukuhara; Koji Takeda; Arthur Reshad Garan; Paul Kurlansky; Jonathan Hastie; Yoshifumi Naka; Hiroo Takayama Journal: Gen Thorac Cardiovasc Surg Date: 2016-02-13
Authors: M Carl; A Alms; J Braun; A Dongas; J Erb; A Goetz; M Goepfert; W Gogarten; J Grosse; A R Heller; M Heringlake; M Kastrup; A Kroener; S A Loer; G Marggraf; A Markewitz; D Reuter; D V Schmitt; U Schirmer; C Wiesenack; B Zwissler; C Spies Journal: Ger Med Sci Date: 2010-06-15
Authors: Jonathan W Haft; Francis D Pagani; Matthew A Romano; Christina L Leventhal; D Bradley Dyke; Jennifer C Matthews Journal: Ann Thorac Surg Date: 2009-09 Impact factor: 4.330
Authors: Prashant N Mohite; Anton Sabashnikov; Nikhil P Patil; Diana García Sáez; Bartlomiej Zych; Aron F Popov; Alexander Weymann; Thorsten Wahlers; Nandor Marczin; Fabio DeRobertis; Toufan Bahrami; Mohamed Amrani; André R Simon Journal: J Artif Organs Date: 2014-06-01 Impact factor: 1.731