Application Of Intra-aortic Balloon Counterpulsation In Perioperative Critical Care Patients Undergoing Coronary Artery Bypass Grafting

Objective: To analyze the hemodynamic effects and application results of intra-aortic balloon pump(IABP) in 33 critically ill patients with coronary artery bypass graft(CABG).Methods:33 critically ill patients treated with IABP during the perioperative period of CABG in the Department of Cardiac Surgery,Second Hospital of Hebei Medical University from September 2015 to December 2018.The hemodynamic parameters of IABP before operation,1 hour after operation,2 hours after operation,6 hours after operation,12 hours after operation,24 hours after operation were counted,and the state of the patient at the corresponding time point(awake or not)was observed,and dose,positive inotropic drug dosage,body temperature;And IABP before and after left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),IABP use time,ventilator assist time,ICU stay time,postoperative hospital stay,IABP related complications and other perioperative outcomes.To analyze the indications,clinical efficacy,and results of IABP in critically ill patients with CABG.Results:Systolic blood pressure,diastolic blood pressure and mean arterial pressure were increased at 1h,2h,6h,12 h and 24 h after IABP.The heart rate at 6h,12 h and 24 h after IABP decreased compared with that before implantation.The heart rate at 1h and 2h after IABP was not significantly improved compared with that before implantation.Compared with central venous pressure,arterial oxygen saturation,LVEF,and LVEDD before and after IABP placement,P>0.05,there was no statistically significant difference.After the patient is placed with IABP,the cardiac function can be improved.The positive inotropic drugs such as dopamine are gradually reduced or even stopped,and the hemodynamics of the patient is gradually stable.There were 10 hospital deaths and the mortality rate was 30.3%.There were no deaths associated with IABP complications.Conclusions:1.IABP can significantly improve the hemodynamics of critically ill patients with CABG perioperative period,but the hospital mortality is still high.Central-derived shock,multiple organ failure,and malignant arrhythmia are common causes of death.2.The incidence of complications associated with IABP is low and clinically safer.3.If the patient is hemodynamically unstable,if there is no absolute contraindication,IABP should be placed as soon as possible.