Intraoperative Application of Intraaortic Balloon Counterpulsation Determined by Clinical Monitoring of the Endocardial Viability Ratio

摘要: Abstract Persistent unrecognized subendocardial ischemia with development of necrosis is a major cause patient death following cardiopulmonary bypass. The lesion caused by discrepancy between the oxygen needs muscle and available blood supply. If sole reliance placed upon monitoring conventional vital signs, more subtle factors contributing to decreased flow may go unrecognized. Reported studies have confirmed that adequacy perfusion can be predicted calculating supply/demand ratio, defined as ratio diastolic pressure-time index (DPTI) divided systolic (TTI). An analog computer was designed built measures area under component, calculates DPTI/TTI digitally displays result endocardial viability (EVR). EVR used determine left ventricular in 64 consecutive patients undergoing cardiac operations. Unidirectional intraaortic balloon counterpulsation (IABC) utilized 14 9 long-term survivors. difference mean survivors nonsurvivors at initiation support statistically significant. Early application unidirectional IABC when persists open procedures prevent deterioration subsequent morbidity or mortality.