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Intra‐aortic Balloon Pump‐induced Pulsatile Flow Reduces Coagulative and Fibrinolytic Response to Cardiopulmonary Bypass
Author(s) -
Onorati Francesco,
Esposito Antonio,
Comi Maria Caterina,
Impiombato Barbara,
Cristodoro Lucia,
Mastroroberto Pasquale,
Renzulli Attilio
Publication year - 2008
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.2008.00563.x
Subject(s) - cardiopulmonary bypass , medicine , partial thromboplastin time , pulsatile flow , hematocrit , fibrinogen , perfusion , cardiology , peristaltic pump , anesthesia , coagulative necrosis , oxygenator , antithrombin , platelet , heparin , physics , meteorology
The aim of this study is to evaluate if a simple intra‐aortic balloon pump (IABP)‐induced pulsatile perfusion reduces activation of coagulative system during cardiopulmonary bypass (CPB). Ninety‐six patients undergoing preoperative IABP were randomized to nonpulsatile CPB with IABP discontinued during cardioplegic arrest (Group A) or IABP‐induced pulsatile CPB (Group B). White blood cells (WBC), hematocrit (Ht), platelets (PLTs), International Normalized Ratio (INR), fibrinogen, activated partial thromboplastin time (aPTT), antithrombin III (AT‐III) activity, and D‐dimer were measured at the end of surgery (ES) and postoperatively. Chest drainage, need for reexploration, and transfusions were compared. Group B showed lower chest drainage (1st day P = 0.038; 2nd day P = 0.044), transfusions ( P = 0.031), WBC ( P < 0.05 at all time points), and INR ( P < 0.05 at all time points), together with a higher Ht ( P < 0.05 at ES, 12 h), platelets ( P < 0.04 at all time points), fibrinogen ( P < 0.05 at ES, 12 h, 24 h), and aPTT ( P < 0.05 at all time points). AT‐III activity lowered in Group A ( P = 0.001 at ES, 12 h, 24 h), together with higher D‐dimer levels ( P < 0.05 at all time points). IABP‐induced pulsatile perfusion ameliorates coagulative system activation following CPB.