Abstract:
Objective To explore and analyze the incidence and risk factors of complications in the perioperative period of aortic balloon counterpulsation (IABP) in the perioperative period of cardiac surgery.
Methods From January 2011 to December 2016, a retrospective analysis of 80 patients with IABP who underwent cardiac surgery from January 2011 to December 2016 was divided into study group (12 cases) and non-complication group (68 cases) according to the incidence of complications after IABP implantation. General information, preoperative complications, perioperative conditions, IABP placement and IABP related complications were collected, and correlation analysis was done by regression analysis.
Results There were no significant differences in gender, age, body mass index, hypertension, and stroke incidence between the two groups (P>0.05). There were significant differences in the percentage of patients over 65 years old, the incidence of diabetes, the incidence of peripheral vascular disease and rate of application of in vitro membrane oxygenation (P<0.05). The risk factors of IABP implantation complication were elderly patients (65 years old), diabetes, peripheral vascular disease and extracorporeal membrane oxygenation. In the study group, the proportion of patients over the age of 65 years(83.33%), the incidence rate of diabetes (41.67%), peripheral vascular disease incidence rate (66.67%) and the application of the extracorporeal membrane oxygenation rate (41.67%) were significantly higher than that in non-complication group. There were no significant differences in the auxiliary time of IABP and the timing of placement between the two groups (P>0.05). The mean arterial pressure and urine volume of the two groups were significantly increased after treatment, and the central venous pressure, heart rate, dopamine and epinephrine were decreased significantly and the difference were statistically significant (P < 0.05). 26 patients underwent preoperative placement, 35 patients underwent intraoperative placement, and 19 patients underwent postoperative complication. The complication rates were 7.69%, 11.43%, and 31.58%, respectively. There were 7 cases (8.75%) after hemorrhage and 2 cases (2.50%) with ischemia, including 1 case of gangrene, 1 case of compartment syndrome, 2 cases of vascular injury, and 1 case of IABP failure.
Conclusion The results of this study confirm that the incidence of complications associated with IABP is low . Local bleeding and limb ischemia are common clinical complications. Advanced age, diabetes, peripheral vascular disease and extracorporeal membrane oxygenation are independent risk factors for IABP complications. In clinical application, perioperative nursing care can be strengthened and operation process can be standardized to reduce the incidence of complications.
Key words:
Intra-aortic balloon pump,
Risk factor,
Cardiac surgery,
Complication
keram Bahtiyar·, rahim Minawar·. Analysis of complications and related factors of intra aortic balloon counterpulsation in the perioperative period of cardiac surgery[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2018, 04(03): 152-156.