Weaning from IABP after CABG Surgery: Impact of Serum Lactate Levels as an Early Predictor

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
M. Ladan, D. Javidi, Amin Vahdani, Azar Nazar, Ali Zarin Ara, Y. Alimohamadi
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引用次数: 1

Abstract

Background: Impaired cardiac performance is a frequent presentation after Coronary Artery Bypass Graft (CABG) surgery. Intra-Aortic Balloon Pump (IABP), as a mechanical support, is lifesaving in many cases of low cardiac output state. IABP is needed to be in place from a few hours to a few days. Weaning is usually done according to patients’ hemodynamic response. Up to now, many studies have addressed the withdrawal methods, but few are related to predict the support time. Objectives: This study aimed to evaluate whether high serum lactate levels are early predictors of IABP dependency after CABG surgery. Patients and Methods: This prospective cohort study was performed on 843 patients who underwent CABG surgery from April 2009 to January 2014 in Pars hospital. Among these patients, 47 ones required IABP support and were all entered into our study. Arterial blood samples were collected by 2-hour intervals during the first 12 hours after the operation. Serum lactate levels were compared according to IABP dependency. The data were analyzed using chi-square, t-test, and correlation coefficient and α = 0.05 was considered to be the significance level. Results: Based on the results, 97.8% of the patients (n = 46) were successfully weaned from IABP support and 95.7% (n = 45) survived to discharge from the hospital. Two patients with persistent serum lactate levels > 15 mmol/L in the first 12 hours of IABP support had the worst prognosis. A significant association was found between the mean serum lactate levels ≥ 6 mmol/L in the first 12 hours after the surgery and ≥ 48 hours dependency on IABP (P = 0.030). Conclusions: Prediction of IABP dependency may be possible by measuring serum lactate levels in the first 12 hours after CABG surgery.
CABG手术后IABP的断奶:血清乳酸水平作为早期预测指标的影响
背景:心脏功能受损是冠状动脉搭桥术(CABG)术后常见的表现。主动脉内球囊泵(IABP)作为一种机械支持手段,在许多低心输出量的病例中具有挽救生命的作用。IABP需要在几个小时到几天内到位。通常根据患者血流动力学反应进行脱机。到目前为止,对戒断方法的研究较多,但对戒断时间的预测研究较少。目的:本研究旨在评估高血清乳酸水平是否是CABG术后IABP依赖的早期预测指标。患者和方法:本前瞻性队列研究纳入2009年4月至2014年1月在Pars医院接受CABG手术的843例患者。其中47例患者需要IABP支持,均纳入我们的研究。术后12小时内每隔2小时采集一次动脉血。根据IABP依赖性比较血清乳酸水平。资料采用卡方检验、t检验,相关系数以α = 0.05为显著水平。结果:97.8%的患者(n = 46)成功脱离IABP支持,95.7% (n = 45)存活至出院。2例患者在IABP支持的前12小时内血清乳酸水平持续为bb0 ~ 15mmol /L,预后最差。术后前12小时平均血清乳酸水平≥6 mmol/L与IABP依赖≥48小时之间存在显著相关性(P = 0.030)。结论:通过测量CABG术后最初12小时的血清乳酸水平,可以预测IABP依赖性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Cardiovascular Research Journal
International Cardiovascular Research Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
0.40
自引率
50.00%
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