title: Prophylactic application of an intra-aortic balloon pump in high-risk patients undergoing off-pump coronary artery bypass grafting.
abstract: BACKGROUND
  An intra-aortic balloon pump (IABP) is the most commonly used circulatory assist device in cardiac surgery. We hypothesized that prophylactic application of an IABP improves early clinical outcome of high-risk patients undergoing scheduled off-pump coronary artery bypass grafting (OPCABG).
  
  
  METHODS
  From January 2010 to December 2013, hemodynamically stable, high-risk patients undergoing scheduled OPCABG with preincision use of an IABP were recruited to the IABP group. Using the propensity score-matching method, every patient in the IABP group was matched with another patient (the control group) with a similar propensity score who received an IABP on an as-needed basis during or after OPCABG. Surgical mortality and major morbidity rates were compared between groups.
  
  
  RESULTS
  A total of 116 patient pairs were included in this study. In patients in the IABP group, postoperative low cardiac output and respiratory as well as renal failure were less frequent, intensive care unit stay was shorter, and surgical mortality was lower compared to patients in the control group. In multivariate logistic regression, timing of IABP implantation, as an independent risk factor, was associated with postoperative low cardiac output (OR=2.02, 95% CI 1.28-5.76), respiratory failure (OR=1.86, 95% CI 1.19-4.27), renal failure (OR=2.96, 95% CI 1.51-6.63) and surgical mortality (OR=2.45, 95% CI 1.42-6.07).
  
  
  CONCLUSIONS
  Prophylactic application of an IABP improves postoperative cardiac performance, reduces respiratory and renal complications, and consequently lowers surgical mortality in high-risk patients undergoing scheduled OPCABG.
authors.affiliation: Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, PR China.
authors.forename: WenJun
authors.initials: W
authors.lastname: Ding
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ji
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: YunQing
authors.initials: Y
authors.lastname: Shi
authors.forename: RunHua
authors.initials: R
authors.lastname: Ma
authors.forename: ChunSheng
authors.initials: C
authors.lastname: Wang
mesh_terms: D000789:Angina, Unstable / Q000401:mortality / Q000601:surgery*; D016022:Case-Control Studies; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000378:metabolism
chemical_list: D019210:Troponin I