EFFECT OF USE OF INTRAAORTIC BALLOON PUMP ON HEMODYNAMICS IN PREOPERATIVE AND POSTOPERATIVE CARDIAC PATHOLOGIES
Project no. 134 · Status: Kapanmış · 2017
Summary
Purpose: To evaluate the efficacy of intraaortic balloon pump (IABP) implantation in low cardiac output (LCOP) patients underwent open heart surgery, and to find out prominent hemodynamic and biochemical parameters related with in-hospital mortality. Materials and Methods: Medical charts of patients underwent open heart surgery who required IABP implantation due to LCOP in our clinic between January 2018 and June 2020 were reviewed retrospectively. Demographics, preoperative, intraoperative, and postoperative data, hemodynamic alterations seen in early period of IABP implantation, inotropic support requirement, intensive care unit (ICU) and hospital stay durations, changes in biochemical parameters, and complications related with IABP implantation were documented. After study population divided into two groups according to mortality, statistical analyses were performed to investigate the effects of studied parameters over mortality. Results: Gender, indication of surgery, and additional surgical procedure requirement, as well as cardiopulmonary and aortic cross-clamp time were not related with mortality rate after IABP implantation (p=0.745, p=0.853, p=0.842, p=0.520, and p=0.456, respectively); whereas mortality was higher in older patients (p=0.037). Despite IABP implantation, mortality was found as 51.9% in our study population; however, it was lower in cases with early IABP implantation constituting 55.5% of the entire group (p=0.031). In 52 patients who were clinically stabilized and recharged from ICU after a mean of 5.2±2.9 days, significant increase in systolic, diastolic, and mean arterial blood pressures (p<0.001 for each), as well as urine output per hour (p<0.001); and decrease in inotropic requirement (p<0.001) were found. Independent risk factors affecting mortality rate were found as lower diastolic arterial blood pressure (p=0.038, OR:0.909, %95CI:0.831–0.995) and lower urine output (p=0.038, OR:0.984, %95CI:0.969–0.999) at six hours after implantation; as well as lower urine output (p=0.029, OR:0.971, %95CI:0.946–0.997), higher inotropic requirement (p=0.031, OR:4.857, %95CI:1.155– 20.429), and higher serum creatinine level (p=0.040, OR:13.632, %95CI:1.128–164.767) at 24 hours after IABP implantation. Conclusion: Early IABP implantation increases the survival rate in cases with LCOP underwent open heart surgery. Implantation of additional support devices should be recommended in cases with the lack of improvement in hemodynamic and biochemical parameters at 48 hour after IABP implantation