The Optimal Weaning Strategy for Intraaortic Balloon Counterpulsation: Volume-Based Versus Rate-Based Approach in an Animal Model.

Autor:	Gelsomino S; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Heart and Vessels, Careggi Hospital, Florence, Italy. Electronic address: sandro.gelsomino@maastrichtuniversity.nl., Lozekoot PW; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Lorusso R; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., de Jong MJ; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Parise O; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Matteucci F; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Lucà F; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Kumar N; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Romano M; Department of Heart and Vessels, Careggi Hospital, Florence, Italy., Gensini GF; Department of Heart and Vessels, Careggi Hospital, Florence, Italy., La Meir M; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Cardiothoracic Surgery, University Hospital, Brussels, Belgium., Maessen JG; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2016 Apr; Vol. 101 (4), pp. 1485-93. Date of Electronic Publication: 2015 Dec 17.
DOI:	10.1016/j.athoracsur.2015.10.010
Abstrakt:	Background: Changes in hemodynamics, coronary circulation, visceral flow, and biochemical marker rate reduction or volume deflation for intraaortic balloon pump discontinuation were assessed. Methods: Twelve healthy pigs were randomly assigned to two groups, the rate-based (RB, n = 6) and volume-based weaning groups (VB, n = 6). Hemodynamics and visceral and coronary flows were measured at baseline after 2 hours of intraaortic balloon pump 1:1, during the first 5 hours of weaning (frequency rate reduced to 1:2 in the RB group and volume decreased by 10%/h in the VB group), after 1 hour of frequency rate 1:3 in the RB group or a volume decrease by 75% in the VB group, 2 hours after withdrawal, and 4 hours after withdrawal. Results: The animals weaned by progressive VB deflation showed a greater degree of vasodilation, better cardiac output and stroke volume, fewer negative values of cardiac cycle efficiency, and higher dP/dTmax compared with those weaned by RB reduction (p < 0.05 for all). The VB group also exhibited increased coronary flow, lower oxygen consumption of the myocardium, and coronary resistance during VB weaning (p < 0.05 for all). The serum lactate level was lower in the VB group at each experimental point (p < 0.05 for all), but visceral flows were scarcely affected by the weaning method. Conclusions: Volume reduction was the most effective weaning method considering that frequency reduction weaning was responsible for significant negative effects on hemodynamics and coronary circulation. (Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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