Document Detail


Prognosis after the implantation of an intra-aortic balloon pump in cardiac surgery calculated with a new score.
MedLine Citation:
PMID:  12354734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Harald Hausmann; Evgenij V Potapov; Andreas Koster; Thomas Krabatsch; Julia Stein; Ruhi Yeter; Marian Kukucka; Ralf Sodian; Hermann Kuppe; Roland Hetzer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  106     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-30     Completed Date:  2002-10-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  I203-6     Citation Subset:  AIM; IM    
Affiliation:
Deutsches Herzzentrum Berlin, Berlin, Germany. hhausmann@dhzb.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Output, Low / mortality,  physiopathology,  surgery*
Coronary Artery Bypass
Female
Heart-Assist Devices
Hemodynamics
Humans
Intra-Aortic Balloon Pumping*
Logistic Models
Male
Multivariate Analysis
Pilot Projects
Prognosis
Retrospective Studies
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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