کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5964852 1576143 2016 13 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Efficacy and safety of preoperative intra-aortic balloon pump use in patients undergoing cardiac surgery: a systematic review and meta-analysis
ترجمه فارسی عنوان
اثربخشی و ایمنی استفاده از پمپ بالون داخل پره قبل از عمل در بیماران تحت جراحی قلب: یک بررسی سیستماتیک و متاآنالیز
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

BackgroundIntra-aortic balloon pump (IABP) can be used prior to coronary artery bypass graft surgery (CABG) in high-risk patients. Whether this technique remains safe and effective in contemporary practice is controversial.ObjectiveWe have completed a systematic review and meta-analysis of randomized trials and observational studies to evaluate the safety and benefits of IABP prior to CABG surgery.MethodsWe searched PubMed, EMBASE, Cochrane Library databases, with cross-referencing of relevant articles for studies assessing the impact of IABP prior to and after isolated CABG. Two investigators independently sorted the potentially relevant studies, and three extracted data. The assessed outcomes included in-hospital and 30-day mortality, IABP-related complications and length of intensive care unit and hospital stay.ResultsFrom 1977 to 2015 we included 11 randomized controlled trials (n = 1293) (RCTs) and 22 observational studies, including a total of 46,067 patients. Analyses from RCTs suggested that IABP prior to CABG was associated with a significant reduction in hospital mortality (odds ratio (OR) 0.20; 95% confidence interval (CI): 0.09-0.44; P < 0.0001) and 30-day mortality compared to no preoperative IABP (OR 0.43, 95% CI: 0.25-0.76; P = 0.003). IABP prior to CABG was also associated with shorter intensive care unit (weighted mean difference (WMD) − 1.47 day; 95% CI: − 1.82 to − 1.12 day; P < 0.00001) and hospital length of stay (WMD − 3.25 days; 95% CI: − 5.18 to − 1.33 days; P = 0.0009). However, there were significant bias and limitations among included studies. Furthermore, results for similar outcomes from observational studies remained inconclusive.ConclusionsIn contemporary practice, evidence showing clinical benefit for preoperative IABP in high-risk patients remains limited and requires further validation in an appropriately sized multicenter randomized trial.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Cardiology - Volume 207, 15 March 2016, Pages 67-79
نویسندگان
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