Elena Bignami1, Luigi Tritapepe2, Laura Pasin1, Roberta Meroni1, Laura Corno1, Valentina Testa1, Giovanni Landoni1, Fabio Guarracino3, Alberto Zangrillo1
1 Department of Anesthesia and Intensive Care, Universitą Vita-Salute San Raffaele, Milan, Italy
2 Department of Anesthesiology and Intensive Care, La Sapienza University, Rome, Italy
3 Department of Cardiothoracic Anaesthesia and Intensive Care Medicine, University Hospital of Pisa, Pisa, Italy
Intra-aortic balloon pump (IABP) is an established tool in the management of cardiac dysfunction in cardiac surgery. The best timing for IABP weaning is unknown and varies greatly among cardiac centers. The authors investigated the differences in IABP management among 66 cardiac surgery centers performing 40,675 cardiac surgery procedures in the 12-month study period. The centers were contacted through email, telephone, or in person interview. IABP management was very heterogeneous in this survey: In 43% centers it was routinely removed on the first postoperative day, and in 34% on the second postoperative day. In 50% centers, it was routinely removed after extubation of the patients whereas in 15% centers it was removed while the patients were sedated and mechanically ventilated. In 66% centers, patients were routinely receiving pharmacological inotropic support at the time of removal of IABP. The practice of decreasing IABP support was also heterogeneous: 57% centers weaned by reducing the ratio of beat assistance whereas 34% centers weaned by reducing balloon volume. We conclude that the management of IABP is heterogeneous and there is a need for large prospective studies on the management of IABP in cardiac surgery.
Department of Cardiothoracic Anesthesia and Intensive Care, San Raffaele Hospital, Via Olgettina 60 Milan 20132
Source of Support: None, Conflict of Interest: None
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