title: Prolonged use for at least 10 days of intraaortic balloon pumping (IABP) for heart failure.
abstract: Intraaortic balloon pumping (IABP) is a useful therapy for refractory heart failure. However, the safe duration of this therapy and possible complications due to long-term IABP support remain unclear. In this study, we reviewed retrospectively patients requiring the long-term use of IABP, defined here as 10 days or more, to estimate the background and prognosis of patients undergoing long-term use of IABP. The characteristics and perioperative status were compared between survivors and nonsurvivors. A total of 18 patients including 12 males and 6 females required long-term IABP use. IABP was induced in 13 patients (72%) following cardiac surgery and in 5 without cardiac surgery. The mean duration of IABP support was 17 +/- 7 days. Seven patients survived and 11 died of heart failure and/or associated other organ failure. Multiple organ failure (MOF) was recognized in 10 patients, and the incidence of MOF was significantly (P = 0.005) lower in the survivors (14%) compared to the nonsurvivors (82%). The percentage of postcardiac surgery patients was also significantly (P = 0.027) higher in nonsurvivors (91%) than in survivors (43%). Logistic regression analysis identified MOF and cardiac surgery as independent predictors for death. Femoral arterial-venous fistula was the only IABP-related complication. In patients receiving long-term IABP, attention should be paid to other organ complications associated with heart failure, and the use of other circulatory supports such as PCPS or VAD to avoid MOF should be considered if necessary.
authors.affiliation: Intensive Care Unit, Gunma University Hospital, Japan.
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Oshima
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hinohara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kadoi
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tajima
authors.forename: Fumio
authors.initials: F
authors.lastname: Kunimoto
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006351:Heart Valves / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*; D011184:Postoperative Period; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors