The aim of this study is to evaluate if a simple intra-aortic balloon pump (IABP)-induced pulsatile perfusion reduces activation of coagulative system during cardiopulmonary bypass (CPB). Ninety-six patients undergoing preoperative IABP were randomized to nonpulsatile CPB with IABP discontinued during cardioplegic arrest (Group A) or IABP-induced pulsatile CPB (Group B). White blood cells (WBC), hematocrit (Ht), platelets (PLTs), International Normalized Ratio (INR), fibrinogen, activated partial thromboplastin time (aPTT), antithrombin III (AT-III) activity, and D-dimer were measured at the end of surgery (ES) and postoperatively. Chest drainage, need for reexploration, and transfusions were compared. Group B showed lower chest drainage (1st day P = 0.038; 2nd day P = 0.044), transfusions (P = 0.031), WBC (P < 0.05 at all time points), and INR (P < 0.05 at all time points), together with a higher Ht (P < 0.05 at ES, 12 h), platelets (P < 0.04 at all time points), fibrinogen (P < 0.05 at ES, 12 h, 24 h), and aPTT (P < 0.05 at all time points). AT-III activity lowered in Group A (P = 0.001 at ES, 12 h, 24 h), together with higher D-dimer levels (P < 0.05 at all time points). IABP-induced pulsatile perfusion ameliorates coagulative system activation following CPB.

Intra-aortic balloon pump-induced pulsatile flow reduces coagulative and fibrinolytic response to cardiopulmonary bypass

Onorati, F;
2008

Abstract

The aim of this study is to evaluate if a simple intra-aortic balloon pump (IABP)-induced pulsatile perfusion reduces activation of coagulative system during cardiopulmonary bypass (CPB). Ninety-six patients undergoing preoperative IABP were randomized to nonpulsatile CPB with IABP discontinued during cardioplegic arrest (Group A) or IABP-induced pulsatile CPB (Group B). White blood cells (WBC), hematocrit (Ht), platelets (PLTs), International Normalized Ratio (INR), fibrinogen, activated partial thromboplastin time (aPTT), antithrombin III (AT-III) activity, and D-dimer were measured at the end of surgery (ES) and postoperatively. Chest drainage, need for reexploration, and transfusions were compared. Group B showed lower chest drainage (1st day P = 0.038; 2nd day P = 0.044), transfusions (P = 0.031), WBC (P < 0.05 at all time points), and INR (P < 0.05 at all time points), together with a higher Ht (P < 0.05 at ES, 12 h), platelets (P < 0.04 at all time points), fibrinogen (P < 0.05 at ES, 12 h, 24 h), and aPTT (P < 0.05 at all time points). AT-III activity lowered in Group A (P = 0.001 at ES, 12 h, 24 h), together with higher D-dimer levels (P < 0.05 at all time points). IABP-induced pulsatile perfusion ameliorates coagulative system activation following CPB.
intra-aortic balloon pump
pulsatile flow
cardiopulmonary bypass
coagulation
fibrinolysis
bleeding
Aged
Coronary Artery Bypass
Female
Fibrinogen
Fibrinolysis
Hematologic Tests
Hemodynamics
Humans
Male
Middle Aged
Cardiopulmonary Bypass
Hemostasis, Surgical
Intra-Aortic Balloon Pumping
Pulsatile Flow
File in questo prodotto:
File Dimensione Formato  
Pulsatile_CPB_IABP_coagulation_fibrinolysis_AO2008.pdf

non disponibili

Tipologia: Versione dell'editore
Licenza: Accesso ristretto
Dimensione 150.13 kB
Formato Adobe PDF
150.13 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11562/1025550
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 22
  • ???jsp.display-item.citation.isi??? 22
social impact