Key result
Rescue IABP for CABG instability is linked to a ~14% absolute increase in discharge EF.
Why the study?
The study was conducted to evaluate the efficacy of IABP as intraoperative rescue mechanical support for persistent hemodynamic instability during elective on-pump CABG surgery.
Does intraoperative rescue IABP insertion improve hemodynamics and clinical outcomes in patients with persistent hemodynamic instability during on-pump CABG?
Observational (n=40)
No
Does intraoperative rescue IABP insertion improve hemodynamics and clinical outcomes in patients with persistent hemodynamic instability during on-pump CABG?
Absolute Event Rate: 50.56% vs 36.26%
p-value: p=<0.0001
Intraoperative rescue IABP insertion significantly improved hemodynamics and ejection fraction with no 30-day mortality in patients experiencing persistent hemodynamic instability during on-pump CABG.
Supports rescue IABP in unstable on-pump CABG; leaves open effects on mortality and requires randomized confirmation.
Background: Aim: Aim of this study was to evaluate the efficacy of IABP as a rescue mechanical support intra-operatively in persistent hemodynamic instability in a group of patients who have undergone elective CABG surgery.Subjects and Methods: It is a retrospective study conducted on patients who have undergone on pump CABG and received rescue IABP support intraoperatively.The IABP was inserted in the presence of hemodynamic instability as a rescue, inserted percutaneously via right or left femoral artery approach.Results: There is a marginal increase in the duration of mechanical ventilation 68.99±30.93hours and duration of ICU stay 5.97±1.93days.All patients had significant ST-T changes in more than 2 leads.No major complications related to IABP were recorded.An echocardiogram shown significant improvement in EF (p value=<0.0001).No in-hospital and 30 days mortality was recorded.Conclusion: This study shows significant improvement in hemodynamics post IABP insertion; improvement in EF at discharge from hospital and no mortality at discharge from hospital and 30 days postoperatively.IABP also decreased the postoperative length of stay.Preoperative IABP suggesting that it is effective in patients with severe LV dysfunction undergoing OPCAB.
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Harish et al. (2019) conducted an observational in Persistent intraoperative hemodynamic instability during on-pump CABG (n=40). Intra-Aortic Balloon Pump (IABP) vs. Baseline (Pre-IABP insertion) was evaluated on Ejection Fraction (EF) at discharge (p=<0.0001). Rescue IABP insertion in patients with persistent intraoperative hemodynamic instability during on-pump CABG significantly improved ejection fraction from 36.26% to 50.56% at discharge.
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