TY - JOUR
T1 - The Optimal Weaning Strategy for Intraaortic Balloon Counterpulsation
T2 - Volume-Based Versus Rate-Based Approach in an Animal Model
AU - Gelsomino, Sandro
AU - Lozekoot, Pieter W J
AU - Lorusso, Roberto
AU - de Jong, Monique J.
AU - Parise, Orlando
AU - Matteucci, Francesco
AU - Lucà, Fabiana
AU - Kumar, Narendra
AU - Romano, Mario
AU - Gensini, Gian Franco
AU - La Meir, Mark
AU - Maessen, Jos G.
PY - 2015
Y1 - 2015
N2 - Background: Changes in hemodynamics, coronary circulation, visceral flow, and biochemical marker rate reduction or volume deflation for intraaortic balloon pump discontinuation were assessed. Methods: Twelve healthy pigs were randomly assigned to two groups, the rate-based (RB, n = 6) and volume-based weaning groups (VB, n = 6). Hemodynamics and visceral and coronary flows were measured at baseline after 2 hours of intraaortic balloon pump 1:1, during the first 5 hours of weaning (frequency rate reduced to 1:2 in the RB group and volume decreased by 10%/h in the VB group), after 1 hour of frequency rate 1:3 in the RB group or a volume decrease by 75% in the VB group, 2 hours after withdrawal, and 4 hours after withdrawal. Results: The animals weaned by progressive VB deflation showed a greater degree of vasodilation, better cardiac output and stroke volume, fewer negative values of cardiac cycle efficiency, and higher dP/dTmax compared with those weaned by RB reduction (p <0.05 for all). The VB group also exhibited increased coronary flow, lower oxygen consumption of the myocardium, and coronary resistance during VB weaning (p <0.05 for all). The serum lactate level was lower in the VB group at each experimental point (p <0.05 for all), but visceral flows were scarcely affected by the weaning method. Conclusions: Volume reduction was the most effective weaning method considering that frequency reduction weaning was responsible for significant negative effects on hemodynamics and coronary circulation.
AB - Background: Changes in hemodynamics, coronary circulation, visceral flow, and biochemical marker rate reduction or volume deflation for intraaortic balloon pump discontinuation were assessed. Methods: Twelve healthy pigs were randomly assigned to two groups, the rate-based (RB, n = 6) and volume-based weaning groups (VB, n = 6). Hemodynamics and visceral and coronary flows were measured at baseline after 2 hours of intraaortic balloon pump 1:1, during the first 5 hours of weaning (frequency rate reduced to 1:2 in the RB group and volume decreased by 10%/h in the VB group), after 1 hour of frequency rate 1:3 in the RB group or a volume decrease by 75% in the VB group, 2 hours after withdrawal, and 4 hours after withdrawal. Results: The animals weaned by progressive VB deflation showed a greater degree of vasodilation, better cardiac output and stroke volume, fewer negative values of cardiac cycle efficiency, and higher dP/dTmax compared with those weaned by RB reduction (p <0.05 for all). The VB group also exhibited increased coronary flow, lower oxygen consumption of the myocardium, and coronary resistance during VB weaning (p <0.05 for all). The serum lactate level was lower in the VB group at each experimental point (p <0.05 for all), but visceral flows were scarcely affected by the weaning method. Conclusions: Volume reduction was the most effective weaning method considering that frequency reduction weaning was responsible for significant negative effects on hemodynamics and coronary circulation.
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U2 - 10.1016/j.athoracsur.2015.10.010
DO - 10.1016/j.athoracsur.2015.10.010
M3 - Article
C2 - 26706752
AN - SCOPUS:84954271593
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
ER -