The current practice of intra-aortic balloon counterpulsation: Results from the Benchmark Registry
The current practice of intra-aortic balloon counterpulsation: Results from the Benchmark Registry
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DOI：
10.1016/s0735-1097(01)01553-4
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发表时间：
2001-11-01
影响因子：
24
通讯作者：
Ohman, EM
中科院分区：
文献类型：
--
作者：
Ferguson, JJ;Cohen, M;Ohman, EM
本研究提供了来自首个大型主动脉反搏登记处的临床数据，该登记处是一个计算机化数据库，包含前瞻性收集的关于主动脉内球囊反搏（IABP）使用适应症、患者人口统计学、背景主动脉内球囊反搏（IABP）广泛用于为由于心肌梗塞、心源性休克方法1996年6月至2000年8月，全世界203家医院（90%美国，10%非美国）收集了16，909份患者病例记录（68.8%男性，31.2%女性;平均年龄65.9 ± 11.7岁）。在心导管插入术期间或之后提供血流动力学支持（20.6%）、心源性休克（18.8%）、体外循环脱机（16.1%）、高危患者术前用药（13.0%）和难治性不稳定型心绞痛（12.3%）。2.6%的病例发生了严重的IABP并发症（严重肢体缺血、严重出血、球囊泄漏、直接由于IABP插入或失败导致的死亡）;院内死亡率为21.2%（球囊就位时为11.6%）。女性性别，高年龄和外周血管疾病是独立的预测因子的严重complication.CONCLUSIONS这个注册表提供了一个有用的工具，用于监测IABP的不断发展的做法。在IABP的现代实践中，并发症发生率通常较低，但住院死亡率仍然很高。女性、老年患者和外周血管疾病患者发生重大并发症的风险增加。（J Am科尔心脏病学杂志2001;38：1456-62）（C）2001年美国心脏病学会。
OBJECTIVES This study presents clinical data from the first large registry of aortic counterpulsation, a computerized database that incorporates prospectively gathered data on indications for intra-aortic balloon counterpulsation (IABP) use, patient demographics, concomitant medication and in-hospital outcomes and complications.BACKGROUND The intra-aortic balloon pump (IABP) is widely used to provide circulatory support for patients experiencing hemodynamic instability due to myocardial infarction, cardiogenic shock, or in very high risk patients undergoing angioplasty or coronary artery bypass grafting.METHODS Between June 1996 and August 2000, 203 hospitals worldwide (90% U.S., 10% non-U.S.) collected 16,909 patient case records (68.8% men, 31.2% women; mean age 65.9 +/- 11.7 years).RESULTS The most frequent indications for use of IABP were as follows: to provide hemodynamic support during or after cardiac catheterization (20.6%), cardiogenic shock (18.8%), weaning from cardiopulmonary bypass (16.1%), preoperative use in high risk patients (13.0%) and refractory unstable angina (12.3%). Major IABP complications (major limb ischemia, severe bleeding, balloon leak, death directly due to IABP insertion or failure) occurred in 2.6% of cases; in-hospital mortality was 21.2% (11.6% with the balloon in place). Female gender, high age and peripheral vascular disease were independent predictors of a serious complication.CONCLUSIONS This registry provides a useful tool for monitoring the evolving practice of IABP. In the modern-day practice of IABP, complication rates are generally low, although in-hospital mortality remains high. There is an increased risk of major complications in women, older patients and patients with peripheral vascular disease. (J Am Coll Cardiol 2001;38:1456-62) (C) 2001 by the American College of Cardiology.