			Home About us Contact

Balloon Pump (balloon + pump)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of Balloon Pump

intra-aortic balloon pump

Selected Abstracts

Preoperative Intra-Aortic Balloon Pump in Patients Undergoing Coronary Bypass Surgery: A Systematic Review and Meta-Analysis

JOURNAL OF CARDIAC SURGERY, Issue 1 2008
Adel M. Dyub M.D., M.Sc.
The primary outcome was hospital mortality and secondary outcomes were IABP-related complications (bleeding, leg ischemia, aortic dissection). Methods: MEDLINE, EMBASE, Cochrane registry of Controlled Trials, and reference lists of relevant articles were searched. We included randomized controlled trials (RCTs), and cohort studies that fulfilled our a priori inclusion criteria. Eligibility decisions, relevance, study validity, and data extraction were performed in duplicate using pre-specified criteria. Meta-analysis was conducted using a random effects model. Results: Ten publications fulfilled our eligibility criteria, of which four were RCTs and six were cohort studies with controls. There were statistical as well as clinical heterogeneity among included studies. A total of 1034 patients received preoperative IABP and 1329 did not receive preoperative IABP. The pooled odds ratio (OR) for hospital mortality in patients treated with preoperative IABP was 0.41 (95% CI, 0.21,0.82, p = 0.01). The number needed to treat was 17. The pooled OR for hospital mortality from randomized trials was 0.18 (95% CI, 0.06,0.57, p = 0.003) and from cohort studies was 0.54 (95% CI, 0.24,1.2, p = 0.13). Overall, 3.7% (13 of 349) of patients who received preoperative IABP developed either limb ischemia or haematoma at the IABP insertion site, and most of these complications improved after discontinuation of IABP. Conclusion: Evidence from this meta-analysis support the use of preoperative IABP in high-risk patients to reduce hospital mortality. [source]

Predictors of Survival 1 Hour After Implantation of an Intra-aortic Balloon Pump in Cardiac Surgery

JOURNAL OF CARDIAC SURGERY, Issue 1 2001
Harald Hausmann M.D.
From July 1996 to March 2000, 391 patients with intraoperative cardiac lowoutput syndrome who underwent surgery with heart-lung bypass and had an intre-aortic balloon pump (IABP) Implanted were analyzed in a prospective study. Of these 391 patients, 153 (39%) were operated on in an emergency situation, and 238 (61%) patients had elective surgeries. 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 ,g/kg/min, a left mrial pressure higher then 15 mmHg, output of less than 100 mL/hour, and mixed venous saturation (SvO2) of less then 60% had poor outcomes. Using this data, we developed an IABP score to predict survival early after IABP implantation in cardiac surgery. We conclude that the success or failure of perioperative IABP support can be predicted early after implantation of the balloon pump. In patients with low-output syndrome despite IABP support, implantation of a vantricular assist system should be considered. [source]

Intra-aortic Balloon Pump Use in the Failing Fontan Circulation

CONGENITAL HEART DISEASE, Issue 1 2008
Adrian M. Moran MB
ABSTRACT Acute cardiogenic shock in patients with Fontan physiology, while uncommon, is associated with devastating outcomes. Management of these patients is increasingly relying on the use of mechanical support. The use of intra-aortic balloon pump is underutilized. This report highlights the successful use of this modality in an adult with Fontan physiology and reviews the literature on this approach in such patients. [source]

Perioperative heart failure in coronary surgery and timing of intra-aortic balloon pump insertion

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2010
M. RANUCCI
Background: Perioperative heart failure (HF) in coronary operations is accompanied by a high operative mortality rate. An intra-aortic balloon pump (IABP) is often used to treat this syndrome. The correct timing for IABP insertion after completion of the operation has not yet been investigated. The aim of this study was to investigate the operative mortality in perioperative HF patients who had undergone coronary operations with respect to the early or the late use of IABP. Methods: This is a retrospective study including 7,270 patients who had undergone coronary surgery with or without associated procedures. A population of patients with perioperative HF was extracted and analyzed with respect to the use of drugs, intra-operative or post-operative IABP to treat this condition. Results: A total of 1,051 (14.5%) patients had perioperative HF. The mortality rate in this group was 13.5%. Early (intra-operative) IABP insertion was performed in 123 patients. In contrast, 928 patients were treated with inotropic drugs only, and, of these patients, 59 developed a drug-refractory HF requiring late IABP insertion. Operative mortality was significantly (P=0.001) higher in patients requiring late (64.4%) vs. early (41.5%) IABP insertion. Independent risk factors for developing a drug-refractory HF were age, pre-operative serum creatinine value and an associated mitral valve procedure. Conclusions: Postponing the use of IABP may be deleterious in patients with drug-refractory HF. In the presence of the three factors independently associated with the risk of a drug-refractory HF, early IABP insertion is suggested. [source]

Predictors and Outcomes Associated with Intraoperative Aortic Dissection in Cardiac Surgery

JOURNAL OF CARDIAC SURGERY, Issue 5 2008
Amber Hurt M.D.
The objective of this study was to assess risk factors of aortic dissection and assess outcomes in patients with aortic dissection experience. Methods: A study from a 10-year hospitalization cohort (N = 12,907) with prospective data collection was conducted. Patients without aortic dissection were matched to 33 aortic dissection patients 3:1 on the type of procedure. The study examined 24 potential confounding risk factors and 12 outcome variables. Results: Univariate analysis on potential confounding risk factors revealed two significant risk factors. There was a significant difference between aortic dissection and nonaortic dissection patients with New York Heart Association (NYHA) functional class (p = 0.03). Patients with aortic dissection were more likely to be in Class I or II. Patients with aortic dissection had significantly longer perfusion time (p = 0.008). There was a significant difference between patients with and without aortic dissection on four outcome variables. Patients with an aortic dissection were more likely to need prolonged ventilation (p = 0.046), have renal failure (p = 0.005), require intraaortic balloon pump (IABP) (0.043), and have a higher mortality rate (p < 0.001). Conclusion: Aortic dissection occurs infrequently during coronary artery bypass grafting, but is a devastating complication and greatly increases morbidity. Although few patients dissect intraoperatively, this study attempted to identify predictors that may label a patient as high risk for possible aortic dissection. Although two factors in this study were statistically significant, they are not reliable preoperative predictors of high-risk patients that can be used to screen patients and help prevent aortic dissection and its sequela. [source]

Predictors of Survival 1 Hour After Implantation of an Intra-aortic Balloon Pump in Cardiac Surgery

Thrombocytopenia in Patients Treated with Heparin, Combination Antiplatelet Therapy, and Intra-Aortic Balloon Pump Counterpulsation

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 4 2008
B.C.P.S., HEATHER R. BREAM-ROUWENHORST Pharm D.
Objectives:Determine the incidence and timing of intra-aortic balloon pump (IABP)-associated thrombocytopenia, if concomitant antiplatelet agents increase the incidence of thrombocytopenia, and the incidence of heparin-induced thrombocytopenia (HIT) in a contemporary IABP population. Background:Previous studies predate the current practice of treating acute coronary syndrome patients with heparin and aspirin plus thienopyridines and glycoprotein IIb/IIIa receptor antagonists such that data are unavailable to determine if their co-administration worsens IABP-associated thrombocytopenia. Methods:A retrospective cohort study of adult IABP patients (n = 107) from 2002 to 2006 was performed to determine the indication for and duration of counterpulsation, platelet counts during and for 7 days postcounterpulsation, medications potentially contributing to thrombocytopenia, and HIT antibody results if obtained. Results:Thrombocytopenia, defined as platelets <150,000/mL or >50% decrease from baseline, occurred in 57.9% of patients. Overall, platelets declined to 60.2 ± 22.8% of baseline with the mean (± standard deviation) nadir on day 2.8 ± 2.0. Comparing patients who received heparin, aspirin, thienopyridines, and glycoprotein IIb/IIIa antagonists (n = 44) versus heparinized patients ± aspirin (n = 45), platelet nadirs were 62.7 ± 20.9% versus 58.3 ± 23.9% of baseline levels, respectively (P = 0.42). The incidence of HIT was 2.8% in the entire cohort. Conclusions:IABP-associated thrombocytopenia occurred in 57.9% of this cohort. HIT was diagnosed in 2.8% and should be considered as a diagnosis if platelet counts do not stabilize or continue to fall after 3,4 days of counterpulsation. Increased use of antiplatelet therapy does not impact the degree of thrombocytopenia although the current practice of prompt IABP removal may offset this effect. [source]

Hemodynamics of a Pulsatile Left Ventricular Assist Device Driven by a Counterpulsation Pump in a Mock Circulation

ARTIFICIAL ORGANS, Issue 4 2006
Ashraf William Khir
Abstract:, The BCM (CardialCare, Minneapolis, MN, U.S.A.) is a pusher-plate pulsatile left ventricular assist device (LVAD) that is operated by counterpulsation pumps. The purpose of this work was to assess the fluid dynamics associated with operating the BCM in a mock circulation, and also to examine the similarities between hemodynamic parameters produced by this device in vitro and those produced by the left ventricle (LV) in vivo. The BCM was connected to a true size silicon rubber aorta and operated by an intra-aortic balloon pump. We examined the performance of the device at two system pressures (6.5 and 8 kPa); at three heart rates (60, 80, and 100 bpm); and at three pumping frequencies (1:1, 1:2, 1:3). Pressure and flow were measured in the upper descending aorta, and wave intensity analysis was used to calculate the peak intensity and energy of the compression and expansion waves. Pressure and flow waveforms produced by the BCM LVAD in vitro under different loading conditions were similar to those observed in vivo under similar loadings. Pusher-plate-type LVADs can produce compression and expansion waves similar to those generated by healthy LV in vivo. [source]

A New Approach to Assist Postoperative Heart Failure in an Animal Model: Juxta-Aortic Counterpulsation

ARTIFICIAL ORGANS, Issue 10 2002
Edmundo I. Cabrera Fischer
Abstract: Aortic counterpulsation is a useful technique frequently used in postcardiotomy heart failure. An acute heart failure model in open chest sheep was chosen to evaluate hemodynamic improvement with a counterpulsation balloon pump in juxta-aortic position. This was achieved with a manufactured Dacron prosthesis and a balloon pump placed between the prosthesis and the aorta. Juxta-aortic balloon pump counterpulsation in acute experimental heart failure resulted in a significant improvement of hemodynamic parameters: increase of cardiac output (from 0.86 ± 0.04 to 1.29 ± 0.09 L/min, p < 0.05) and cardiac index (from 0.03 ± 0.01 to 0.04 ± 0.01 L/min per kg, p < 0.05), and decrease of systemic vascular resistance (from 89.76 ± 6.69 to 66.56 ± 6.02 mm Hg/L per min, p < 0.05). The extent of aortic diastolic pressure change evaluated through the diastolic and systolic areas beneath the aortic pressure curve (DABAC/SABAC) index before cardiac failure induction showed a significant increase compared with unassisted values (from 0.81 ± 0.10 to 1.12 ± 0.09, p < 0.05). Assisted values of DABAC/SABAC index after heart failure induction also showed a significant increase compared with unassisted values (from 0.78 ± 0.21 to 1.17 ± 0.38, p < 0.05). Treatment of experimental acute heart failure by juxta-aortic balloon pump counterpulsation allows an effective hemodynamic improvement in open chest sheep. [source]

Extracorporeal membrane oxygenation bridge to adult heart transplantation

CLINICAL TRANSPLANTATION, Issue 3 2010
Jennifer Chia-Ying Chung
Chung JC, Tsai PR, Chou NK, Chi NH, Wang SS, Ko WJ. Extracorporeal membrane oxygenation bridge to adult heart transplantation. Clin Transplant 2010: 24: 375,380. © 2009 John Wiley & Sons A/S. Abstract:, Extracorporeal membrane oxygenation (ECMO) can rescue some critical patients with circulatory collapse when intra-aortic balloon pump (IABP) and ventricular assist devices (VAD) are not suitable. A subset of these patients can use ECMO for direct bridging, or indirect double bridging via VAD to heart transplantation (HTx). For these patients, we identified risk factors for unsuccessful ECMO bridging, with survival to receiving either HTx or VAD as the measure of success. The characteristics evaluated were age, sex, body mass index, pre-ECMO cardiopulmonary resuscitation (CPR), IABP use, dialysis use, sequential organ failure assessment (SOFA) score, and the etiology of cardiomyopathy. From January 1995 to August 2007, there were 70 adult ECMO patients with the intent to bridge to HTx (male: 55, age: 46 ± 14 yr). Thirty-one patients (44%) were successful in bridging. A stepwise multivariate logistic regression analysis found that age > 50 yr (p = 0.003), pre-ECMO CPR (p = 0.001) and SOFA score > 10 at ECMO initiation (p = 0.018) were significant independent predictors of unsuccessful bridging. Direct VAD implantation, if possible, is preferable to double bridging in patients over 50 yr. Also, elective ECMO support before hemodynamic deterioration to cardiac arrest or multiple organ dysfunction would improve rates of successful ECMO bridging. [source]