Muhammad R K Qureshi, Muhammad Waqas, Muhammad U Saqlain, Ahmed Shahbaz, Jawads Khan, Waqas Sami.
Use of IABP during Intra or Post operative Period of Coronary Artery,.
J Fatima Jinnah Med Coll Lahore Jan ;1(1-2):32-6.

Bypass Graft Surgery (A Prospective, randomized, double blinded Off Pump Vs On Pump Trial) Introduction: IABP is usually the first choice of mechanical devices used for perioperative cardiac failure. The aim of this prospective study was to identify the frequency and duration of IABP use in intra and postoperative period of CABG surgery when subjects are randomly subjected to off pump or on pump surgery, in addition to estimate the risk factors involved in the ultimate outcome of these patients. Patient & Methods: From May 2006 to Feb. 2007, patients who were to undergo Coronary Artery Bypass Graft (CABG) surgery at our center, were randomly subjected to "Off pump" or "On pump" surgery. These patients were then followed prospectively for IABP insertion and their ultimate outcome. During our study period, 522 pts underwent CABG and IABP was used in only 4.4%(23) of patients. Results: The mean age of the patients was 57.43 (±8.34), majority of subjects were male. The most common indication of intra or postoperative use of IABP insertion remained the Inability of patients to be weaned off from cardiopulmonary by pass. The overall in-hospital mortality rate in patients in whom IABP support was used remained 21.7%. The in-hospital mortality for patients >65yrs of age was much higher (p-value=0.01). Duration of IABP was significantly and positively correlated with Cardio Pulmonary Bypass (CPB) time (p-value 0.012) and Aortic Cross Clamp (ACC) time (p-value 0.002). Conclusions: Need of IABP support and the duration for which it is needed in Ultra or postoperative period is less in off pump CABG patients. Although CABG patients represent a high risk group for early mortality, despite this, more than two third of such patients left the hospital alive indicating that IABP use is a very practical option in even in developing regions. Advanced age turned out to be the most significant predictive risk factor for in-hospital mortality. Duration of IABP use Increases with increase of CPB and ACC time.

USER COMMENTS

Intra Aortic Balloon Pump (IABP) The Intra-aortic balloon pump (IABP) is a mechanical device that decreases myocardial oxygen demand while at the same time increasing cardiac output. Increasing cardiac output increases coronary blood flow and therefore myocardial oxygen delivery. It consists of a cylindrical polyethylene balloon that sits in the aorta. That is, it actively deflates in systole, increasing forward blood flow by reducing afterload. It actively inflates in diastole, increasing blood flow to the coronary arteries. These actions combine to decrease myocardial oxygen demand and increase myocardial oxygen supply. http://heart-consult.com/articles/178/intra-aortic-balloon-pump-mechanical-circulatory-support
Posted by: manuheart on Dec 2010

Intra Aortic Balloon Pump (IABP) The Intra-aortic balloon pump (IABP) is a mechanical device that decreases myocardial oxygen demand while at the same time increasing cardiac output. Increasing cardiac output increases coronary blood flow and therefore myocardial oxygen delivery. It consists of a cylindrical polyethylene balloon that sits in the aorta. That is, it actively deflates in systole, increasing forward blood flow by reducing afterload. It actively inflates in diastole, increasing blood flow to the coronary arteries. These actions combine to decrease myocardial oxygen demand and increase myocardial oxygen supply. http://heart-consult.com/articles/178/intra-aortic-balloon-pump-mechanical-circulatory-support
Posted by: manuheart on Dec 2010

My goodness, is this a finding that older people are likely to die more often? With or without IABP, older folks will die more often and p-value for that will be significant, always! This is completely incorrect way of analyzing the role of age on cause-specific mortality. The correct way is to conduct a competing-risk survival analysis.
Posted by: rqayyum on Feb 2011

In most of clinical studies, age is considered as effect modifier rather than a factor, so this effect modifier should be discussed through stratification so its effect to be controlled. Study design is not seen to be a more appropriate. Multivariate analysis should be used in such situation.
Posted by: ibrahim_ap on Oct 2011

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