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Intra‐aortic Balloon Pump‐induced Pulsatile Flow Reduces Coagulative and Fibrinolytic Response to Cardiopulmonary Bypass

2008; Wiley; Volume: 32; Issue: 6 Linguagem: Inglês

10.1111/j.1525-1594.2008.00563.x

1525-1594

Francesco Onorati, Antonio Esposito, Maria Caterina Comi, Barbara Impiombato, Lucia Cristodoro, Pasquale Mastroroberto, Attilio Renzulli,

Cardiac Arrest and Resuscitation

Abstract: 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.