Progressive volume deflation followed by rate reduction in weaning intra-aortic balloon pump_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Hao , HE Yi , YANG Qi , JIANG Xueyan , TANG Min ,  MEI Ju

Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200082, P.R.China;

Corresponding author：

MEI Ju, Email: ju_mei63@126.com

Keywords：

Intra-aortic balloon pump; wean; volume deflation; rate reduction; low cardiac output syndrome

DOI：

10.7507/1007-4848.201702001

Video：

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Objective To investigate the changes of hemodynamics in patients weaning intra-aortic balloon pump (IABP) by using progressive volume deflation followed by rate reduction. Methods We retrospectively analyzed the clinical data of 36 patients aged 68.9±4.7 years, 22 males and 14 females, who underwent progressive volume deflation followed by rate reduction for IABP weaning in Xinhua Hospital between September 2006 and January 2016. Progressive volume deflation followed by rate reduction was used to wean IABP and collect hemodynamics parameters of each time point. Results All the patients successfully weaned IABP. One patient got re-IABP assistant 36 hours after the first successful weaning. One early death and three patients (8%) with postoperative IABP-related complications were embolization of the toe artery. One was in ipsilateral limb, and two of contralateral limb. One patient with acute hepatic insufficiency and one patient with acute renal insufficiency cured after treatment. Conclusion Intra-aortic balloon pump weaning is successful by using volume deflation followed by rate reduction which allowed better hemodynamic parameters.

Citation： LIU Hao, HE Yi, YANG Qi, JIANG Xueyan, TANG Min, MEI Ju. Progressive volume deflation followed by rate reduction in weaning intra-aortic balloon pump. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(3): 188-192. doi: 10.7507/1007-4848.201702001 Copy

1.	Laird JD, Madras PN, Jones RT, et al. Theoretical and experimental analysis of the intra-aortic balloon pump. Trans Am Soc Artif Intern Organs, 1968, 14: 338-343.
2.	Gelsomino S, Renzulli A, Rubino AS, et al. Effects of 1:1, 1:2 or 1:3 intra-aortic balloon counterpulsation/heart support on coronary haemodynamics and cardiac contractile efficiency in an animal model of myocardial ischaemia/reperfusion. Eur J Cardiothorac Surg, 2012, 42(2): 325-332.
3.	De Silva K, Lumley M, Kailey B, et al. Coronary and microvascular physiology during intra-aortic balloon counterpulsation. JACC Cardiovasc Interv, 2014, 7(6): 631-640.
4.	Parissis H, Graham V, Lampridis S, et al. IABP: history-evolution-pathophysiology-indications: what we need to know. J Cardiothorac Surg, 2016, 11(1): 122.
5.	Shahid F, Akhtar M, Khan F, et al. Intra-aortic balloon pump counterpulsation: are we optimizing the management of cardiogenic shock?. J R Soc Med, 2013, 106(2): 51-56.
6.	Thiele H, Schuler G, Neumann FJ, et al. Intraaortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock: Design and rationale of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial. Am Heart J, 2015, 169(4): e7-e8.
7.	Poirier Y, Voisine P, Plourde G, et al. Efficacy and safety of preoperative intra-aortic balloon pump use in patients undergoing cardiac surgery: a systematic review and meta-analysis. Int J Cardiol, 2016, 207: 67-79.
8.	任海波, 李颖, 危宇, 等. 主动脉内球囊反搏在冠状动脉旁路移植术后应用时机研究. 中国胸心血管外科临床杂志, 2015, 22(7): 653-656.
9.	Onorati F, Santini F, Amoncelli E, et al. How should I wean my next intra-aortic balloon pump? Differences between progressive volume weaning and rate weaning. J Thorac Cardiovasc Surg, 2013, 145(5): 1214-1221.
10.	Lewis PA, Mullany DV, Courtney M, et al. Australasian trends in intra-aortic balloon counterpulsation weaning: results of a postal survey. Crit Care Resusc, 2006, 8(4): 361-367.
11.	Cohen M, Fasseas P, Singh VP, et al. Impact of intra-aortic balloon counterpulsation with different balloon volumes on cardiac performance in humans. Catheter Cardiovasc Interv, 2002, 57(2): 199-204.
12.	Malliaras K, Charitos E, Diakos N, et al. Effects of intra-aortic balloon pump counterpulsation on left ventricular mechanoenergetics in a porcine model of acute ischemic heart failure. J Cardiovasc Transl Res, 2014, 7(9): 810-820.
13.	Møller-Helgestad OK, Poulsen CB, Christiansen EH, et al. Support with intra-aortic balloon pump vs. Impella2.5® and blood flow to the heart, brain and kidneys - an experimental porcine model of ischaemic heart failure. Int J Cardiol, 2015, 178: 153-158.
14.	Kolyva C, Pantalos GM, Giridharan GA, et al. Discerning aortic waves during intra-aortic balloon pumping and their relation to benefits of counterpulsation in humans. J Appl Physiol (1985), 2009, 107(5): 1497-1503.
15.	Aye TP, Htet ZL, Singhavilai T, et al. Effect of intra-aortic balloon pump on coronary blood flow during different balloon cycles support: A computer study. Conf Proc IEEE Eng Med Biol Soc, 2015, 2015: 3303-3306.
16.	O’Malley P. Hemodynamic outcomes of weaning intraaortic balloon counterpulsation in heart failure [thesis]. Ohio, USA: Graduate Department, Ohio State University, 2000. 1-30.
17.	Capoccia M, Bowles CT, Pepper JR, et al. Evidence of clinical efficacy of counterpulsation therapy methods. Heart Fail Rev, 2015, 20(3): 323-335.
18.	Onorati F, Cristodoro L, Bilotta M, et al. Intraaortic balloon pumping during cardioplegic arrest preserves lung function in patients with chronic obstructive pulmonary disease. Ann Thorac Surg, 2006, 82(1): 35-43.
19.	Kontoyannis DA, Nanas JN, Kontoyannis SA, et al. Mechanical ventilation in conjunction with the intra-aortic balloon pump improves the outcome of patients in profound cardiogenic shock. Intensive Care Med, 1999, 25(8): 835-838.
20.	Liu H, Wu X, Zhao X, et al. Intra-aortic balloon pump combined with mechanical ventilation for treating patients aged >60 years in cardiogenic shock: Retrospective analysis. J Int Med Res, 2016, 44(3): 433-443.

1. Laird JD, Madras PN, Jones RT, et al. Theoretical and experimental analysis of the intra-aortic balloon pump. Trans Am Soc Artif Intern Organs, 1968, 14: 338-343.
2. Gelsomino S, Renzulli A, Rubino AS, et al. Effects of 1:1, 1:2 or 1:3 intra-aortic balloon counterpulsation/heart support on coronary haemodynamics and cardiac contractile efficiency in an animal model of myocardial ischaemia/reperfusion. Eur J Cardiothorac Surg, 2012, 42(2): 325-332.
3. De Silva K, Lumley M, Kailey B, et al. Coronary and microvascular physiology during intra-aortic balloon counterpulsation. JACC Cardiovasc Interv, 2014, 7(6): 631-640.
4. Parissis H, Graham V, Lampridis S, et al. IABP: history-evolution-pathophysiology-indications: what we need to know. J Cardiothorac Surg, 2016, 11(1): 122.
5. Shahid F, Akhtar M, Khan F, et al. Intra-aortic balloon pump counterpulsation: are we optimizing the management of cardiogenic shock?. J R Soc Med, 2013, 106(2): 51-56.
6. Thiele H, Schuler G, Neumann FJ, et al. Intraaortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock: Design and rationale of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial. Am Heart J, 2015, 169(4): e7-e8.
7. Poirier Y, Voisine P, Plourde G, et al. Efficacy and safety of preoperative intra-aortic balloon pump use in patients undergoing cardiac surgery: a systematic review and meta-analysis. Int J Cardiol, 2016, 207: 67-79.
8. 任海波, 李颖, 危宇, 等. 主动脉内球囊反搏在冠状动脉旁路移植术后应用时机研究. 中国胸心血管外科临床杂志, 2015, 22(7): 653-656.
9. Onorati F, Santini F, Amoncelli E, et al. How should I wean my next intra-aortic balloon pump? Differences between progressive volume weaning and rate weaning. J Thorac Cardiovasc Surg, 2013, 145(5): 1214-1221.
10. Lewis PA, Mullany DV, Courtney M, et al. Australasian trends in intra-aortic balloon counterpulsation weaning: results of a postal survey. Crit Care Resusc, 2006, 8(4): 361-367.
11. Cohen M, Fasseas P, Singh VP, et al. Impact of intra-aortic balloon counterpulsation with different balloon volumes on cardiac performance in humans. Catheter Cardiovasc Interv, 2002, 57(2): 199-204.
12. Malliaras K, Charitos E, Diakos N, et al. Effects of intra-aortic balloon pump counterpulsation on left ventricular mechanoenergetics in a porcine model of acute ischemic heart failure. J Cardiovasc Transl Res, 2014, 7(9): 810-820.
13. Møller-Helgestad OK, Poulsen CB, Christiansen EH, et al. Support with intra-aortic balloon pump vs. Impella2.5® and blood flow to the heart, brain and kidneys - an experimental porcine model of ischaemic heart failure. Int J Cardiol, 2015, 178: 153-158.
14. Kolyva C, Pantalos GM, Giridharan GA, et al. Discerning aortic waves during intra-aortic balloon pumping and their relation to benefits of counterpulsation in humans. J Appl Physiol (1985), 2009, 107(5): 1497-1503.
15. Aye TP, Htet ZL, Singhavilai T, et al. Effect of intra-aortic balloon pump on coronary blood flow during different balloon cycles support: A computer study. Conf Proc IEEE Eng Med Biol Soc, 2015, 2015: 3303-3306.
16. O’Malley P. Hemodynamic outcomes of weaning intraaortic balloon counterpulsation in heart failure [thesis]. Ohio, USA: Graduate Department, Ohio State University, 2000. 1-30.
17. Capoccia M, Bowles CT, Pepper JR, et al. Evidence of clinical efficacy of counterpulsation therapy methods. Heart Fail Rev, 2015, 20(3): 323-335.
18. Onorati F, Cristodoro L, Bilotta M, et al. Intraaortic balloon pumping during cardioplegic arrest preserves lung function in patients with chronic obstructive pulmonary disease. Ann Thorac Surg, 2006, 82(1): 35-43.
19. Kontoyannis DA, Nanas JN, Kontoyannis SA, et al. Mechanical ventilation in conjunction with the intra-aortic balloon pump improves the outcome of patients in profound cardiogenic shock. Intensive Care Med, 1999, 25(8): 835-838.
20. Liu H, Wu X, Zhao X, et al. Intra-aortic balloon pump combined with mechanical ventilation for treating patients aged >60 years in cardiogenic shock: Retrospective analysis. J Int Med Res, 2016, 44(3): 433-443.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Progressive volume deflation followed by rate reduction in weaning intra-aortic balloon pump

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