Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Efficacy of Intra-Aortic Balloon Pump in Postcardiotomy Cardiogenic Shock

개심술 후 인공 심폐기 이탈 시 동맥내 풍선 펌프 사용의 유용성

  • 장지원 (국립암센터) ;
  • 민선경 (이화여자대학교 의과대학 목동병원 흉부외과, 이화여자대학교 흉부외과학교실) ;
  • 원태희 (이화여자대학교 의과대학 목동병원 흉부외과, 이화여자대학교 흉부외과학교실) ;
  • 안재호 (이화여자대학교 의과대학 목동병원 흉부외과, 이화여자대학교 흉부외과학교실)
  • Published : 2002.06.01
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Abstract

Intra-aortic balloon pump (IABP) is well known for its hemodynamic benefit but still has its own complications. Proper use of IABP is the best way to obtain maximum benefit with low complication rate. Material and Method： Twenty one(men 10, female 11) patients were included in this study among the 100 consecutive adult cardiac surgery patients in our hospital. Eighteen(85.7%) were ischemic heart disease patients. They all received IABP therapy due to postcardiotomy cardiogenic shock according to the well-known indications. Their preoperative conditions, intraoperative factors including hemodynamics, postoperative conditions and IABP-related complications were analyzed. Result： Nineteen patients(90.5%) were successfully weaned from IABP. There were 2 patients of operative death and the mortality rate was 9.5%. Duration of IABP use was 40.7$\pm$24.3 hours. There were 2 cases(9.5 %) of IABP-related vascular complications that required surgical intervention. Conclusion： We concluded that IABP could be used effectively and safely for postcardiotomy cardiogenic shock patients with low complication rate.

대동맥내 풍선 펌프는 그 혈류역학적 효용성이 널리 알려져 있으나 자체의 합병증도 가지고 있는 것이 사실이다. 적응증에 의거한 적절한 사용만이 환자에게 최대한의 도움을 주고 합병증을 줄이는 방법이다. 대상 및 방법： 총 100명의 성인 개심술 환자 중 인공 심폐기 이탈을 위해 IABP를 사용한 21명(남 10 여 11)의 환자를 대상으로 하였다. 이들 중 18명(85.7%)은 허혈성 심장질환 환자였다. 대상 환자들의 수술 전 조건, 혈류역학적 변수, 수술 후 상태, IABP 합병증 등을 분석 하였다. 결과： 21명 중 19명(90.5%)의 환자가 성공적으로 IABP에서 이탈하였다. 수술 후 30일 이내에 사망한 환자는 2명(9.5%)이었다. IABP 사용 시간은 40.7$\pm$24.3시간이었으며, 수술을 요하는 IABP관련 혈관 합병증은 2예(9.5%)였다. 결론： IABP는 개심술 후 심인성쇽의 치료에 효과적으로 사용할 수 있는 치료 방법이며 그 합병증 빈도가 낮으므로 안전하게 사용될 수 있는 방법이다.

Keywords

References

  1. J Thorac 2. Cardiovasc Surg v.104 Intra-aortic balloon pumping in patients requiring cardiac operation Naunheim KS;Swartz MT;Pennington DC(et al)
  2. Ann Thorac Surg v.67 Variation in hosptial rates of intraaortic ballon pump use in coronary artery bypass operation Ghali WA;Ash AS;Hall RE;Moskowitz MA https://doi.org/10.1016/S0003-4975(98)01138-2
  3. Ann Thorac Surg v.67 Vascular complication of the intraaortic ballon pump in patients undergoing open heart operation: 15-year experience Arafa OE;Pedersen TH;Svennevig JL;Fosse E;Geiran OR https://doi.org/10.1016/S0003-4975(98)01272-7
  4. Int J Cardiol v.70 Mechanical complications of intra-aortic balloon counterpulsation Kumbasar SD;Semiz E;Sancaktar O;Yalcinkaya S;Deger N https://doi.org/10.1016/S0167-5273(99)00057-1
  5. 대흉외지 v.30 개심술시 Intra-aortic balloon pump(IABP)의 임상적 적용 옥창석;지현근
  6. Am Heart J v.63 Diastolic ballon pumping in aorta: mechanical assistance to failing circulation Moulopoulos SD;Topaz SR;Kolff Wj https://doi.org/10.1016/0002-8703(62)90012-1
  7. Cardiology v.84 Role of intra-aortic counterpulsation in cardiogenic shock and acute myocardial infarction Muller HS https://doi.org/10.1159/000176395
  8. Ann Thorac Surg v.71 Intraaortoc balloon pump therapy facilitates posterior vessels off-pump coronary artery bypass grafting in high risk patients Kim KB;Lim C;Ahn H;Yang JK https://doi.org/10.1016/S0003-4975(01)02638-8
  9. Ann Thorac Surg v.71 Elective intraaortic balloon counterpulsation for high-risk off-pump coronary artery bypass operation Craver JM;Murrah P https://doi.org/10.1016/S0003-4975(00)02685-0
  10. Ann Thorac Surg v.46 Results of intraaortic balloon pumping after cardiac surgery: experience with the Precor balloon catheter Di Lello F;Mullen DC;Flemma RJ;Anderson AJ;Kleinman LH;Wener PH https://doi.org/10.1016/S0003-4975(10)64661-9
  11. Ann Thorac Surg v.55 A model to predict survival at time of postcardiotomy intraaortic balloon pump insertion Baldwin RT;Slogoff S;Noon GP;Sekela M;Frazier H;Edelman SK https://doi.org/10.1016/0003-4975(93)90115-X
  12. Ann Thorac Surg v.71 High lactate predicts the failure of intraaortic balloon pumping after cardiac surgery Davies AR;Bellomo R;Raman JS;Gutteridge GA;Buxton BF https://doi.org/10.1016/S0003-4975(01)02469-9