Routine use of preoperative intra-aortic balloon pump counterpulsation (IABP) implantation in patients with left main coronary artery disease undergoing coronary revascularization surgery
Notice bibliographique
Résumé
Background: Left main coronary artery disease as the only criterion for intra-aortic balloon counterpulsation implantation is an indication which evidence is limited to experts recommendations; therefore, studies that may give a higher level of evidence are required. For this reason, we developed in our institution a study that evaluated the experience in the use of IABP in patients with left main coronary artery disease undergoing coronary revascularization surgery. Objective: describe mortality, length of stay and percentage of infections and sepsis in the intensive care unit, as well as the mechanical ventilation duration in patients undergoing an elective coronary revascularization surgery with or without the use of preoperative intra-aortic balloon counterpulsation. Methods: descriptive retrospective study performed in the Santa Maria Cardiovascular Clinic in patients undergoing elective coronary revascularization surgery with or without the use of preoperative intra-aortic balloon counterpulsation between 1999 and 2003. Postoperative behaviour in patients with severe left main disease (stenosis > 50%) submitted to this surgery was observed. Results: a total of 79 patients submitted to elective surgical revascularization were analyzed. 46 underwent preoperative balloon implantation and 33 underwent surgery without previous balloon implantation. Mean age was 62 years. 67.4% of patients were 60 years or older. Main pathologies previous to surgery were arterial hypertension in 67% of the patients, and ancient acute myocardial infarction in 59%. 87% of the patients with balloon and 45.5% of those without it had severe angina (class III) before surgery. In the intensive care unit 6.5% patients with balloon were infected as well as 3% of the group without balloon (p=0,49) and sepsis was found in 4,3% of the balloon group and none in the non-balloon group (p=0,23). Mortality in the intensive care unit was 2.2% in the balloon group and 3% in the non-balloon group (p=0,06). No intrahospital mortality out of the intensive care unit was reported, nor mortality at 30 days after discharge. Main length of stay in the intensive care unit was 4,13 days in the balloon group and 2,7 in the non-balloon group, with no significant statistical difference (p=0,288). The mean IABP time was 1,32 days and no vascular complications related to its use were found. Conclusions: this study suggests that with routine use of intra-aortic balloon counterpulsation previous to elective coronary revascularization surgery in patients in whom its only indication is severe left main coronary disease, there were no benefits in terms of mortality and length of stay in the intensive care unit or with regard to the mechanical ventilation time. There was no greater risk for developing infection or sepsis in this unit.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».