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Báo cáo y học: "Systematic review: Intra-aortic balloon counterpulsation pump therapy: a critical appraisal of the evidence for patients with acute myocardial infarction"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Systematic review: Intra-aortic balloon counterpulsation pump therapy: a critical appraisal of the evidence for patients with acute myocardial infarction. | Available online http ccforum.eom content 2 1 3 Research Systematic review Intra-aortic balloon counterpulsation pump therapy a critical appraisal of the evidence for patients with acute myocardial infarction John C Peterson1 and Deborah J Cook2 Department of Medicine Division of Cardiology University of Western Ontario London Ontario Canada 2Departments of Epidemiology and Medicine Division of Critical Care McMaster University Faculty of Health Sciences Hamilton Ontario Canada Received 27 February 1998 Published 12 March 1998 1998 Current Science Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Crit Care 1998 2 3 Keywords myocardial infarction cardiogenic shock intra-aortic balloon counterpulsation pump Introduction Intra-aortic balloon counterpulsation pump IABP therapy has been used in several clinical situations predominantly in critically ill patients since 1968 1 . In acute myocardial infarction AMI patients who are experiencing continued ischemia IABP therapy may be used in an attempt to improve patency of an infarct-related coronary artery IRA and reduce the rates of recurrent myocardial ischemia and its sequelae. The mechanism for this benefit is thought to be a combination of reduced oxygen demand 2 increased coronary artery blood flow velocity 3 and augmentation of diastolic arterial pressure enhancing thrombolysis leading to faster reperfusion 4 . IABP therapy may also be used in patients with ventricular septal rupture severe mitral regurgitation and cardiogenic shock. The technique for IABP therapy involves insertion of an 8 or 9.5 Fr helium-filled balloon via the femoral artery into the descending aorta. The device is preferably inserted through an existing vascular access site in an attempt to reduce the rate of vascular and hemorrhagic complications. It is crucial that the tip be positioned distal to the left subclavian artery but proximal to the renal arteries. The balloon is synchronized to deflate during early systole thus decreasing left .