Abstract:
OBJECTIVES:The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN:A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING:Heart Institute of São Paulo University. PATIENTS:High-risk patients undergoing elective coronary artery bypass surgery. INTERVENTION:Patients were randomized to receive preskin incision intra-aortic balloon pump insertion after anesthesia induction versus no intra-aortic balloon pump use. MEASUREMENTS AND MAIN RESULTS:The primary outcome was a composite endpoint of 30-day mortality and major morbidity (cardiogenic shock, stroke, acute renal failure, mediastinitis, prolonged mechanical ventilation, and a need for reoperation). A total of 181 patients (mean [SD] age 65.4 [9.4] yr; 32% female) were randomized. The primary outcome was observed in 43 patients (47.8%) in the intra-aortic balloon pump group and 42 patients (46.2%) in the control group (p = 0.46). The median duration of inotrope use (51 hr [interquartile range, 32-94 hr] vs 39 hr [interquartile range, 25-66 hr]; p = 0.007) and the ICU length of stay (5 d [interquartile range, 3-8 d] vs 4 d [interquartile range, 3-6 d]; p = 0.035) were longer in the intra-aortic balloon pump group than in the control group. A meta-analysis of 11 randomized controlled trials confirmed a lack of survival improvement in high-risk cardiac surgery patients with perioperative intra-aortic balloon pump use. CONCLUSIONS:In high-risk patients undergoing cardiac surgery, the perioperative use of an intra-aortic balloon pump did not reduce the occurrence of a composite outcome of 30-day mortality and major complications compared with usual care alone.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Rocha Ferreira GS,de Almeida JP,Landoni G,Vincent JL,Fominskiy E,Gomes Galas FRB,Gaiotto FA,Dallan LO,Franco RA,Lisboa LA,Palma Dallan LR,Fukushima JT,Rizk SI,Park CL,Strabelli TM,Gelas Lage SH,Camara L,Zeferino S,Jardoi
10.1097/CCM.0000000000003185subject
Has Abstractpub_date
2018-08-01 00:00:00pages
e742-e750issue
8eissn
0090-3493issn
1530-0293journal_volume
46pub_type
杂志文章,随机对照试验abstract:OBJECTIVES:To define a curriculum that outlines the core knowledge residents should possess upon completion of graduate training in order to be able to formulate and initiate a treatment plan for the critically ill patient. DATA SOURCES:Requirements for training program certification as outlined by the Accreditation C...
journal_title:Critical care medicine
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doi:10.1097/00003246-199511000-00020
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To examine the frequency with which quality of life and treatment limitation were discussed in formal family meetings for long-stay intensive care unit patients with high risk for mortality and morbidity. DESIGN:Descriptive observational study. SETTING:Five intensive care units. PATIENTS:One hundred sixtee...
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journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200010000-00001
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To compare the results of cardiac output measurements obtained by lithium dilution and thermodilution. DESIGN:Case series, observational study. SETTING:High-dependency postoperative unit and intensive care unit of a teaching hospital. PATIENTS:Forty patients were studied. Thirty-four patients had undergoin...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199711000-00015
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to test the ability of myoglobin removal of a novel, high-permeability polysulphone dialyzer in acute kidney injury as a result of rhabdomyolysis. SETTING:Intensive care unit of a tertiary care hospital. PATIENTS:Six patients (one female; aged 24, 36, 41, 55, 63, and 65 yrs) ...
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doi:10.1097/CCM.0b013e3181feb7f0
更新日期:2011-01-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199106000-00004
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:Sepsis is a frequent cause of admission, but incidence rates based on administrative data have previously produced large differences in estimates. The aim of the study was to estimate the incidence of community-acquired sepsis based on patients' symptoms and clinical findings at arrival to the hospital. DESI...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000611
更新日期:2015-01-01 00:00:00
abstract::Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infectio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198412000-00003
更新日期:1984-12-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200005000-00048
更新日期:2000-05-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199207000-00018
更新日期:1992-07-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200008000-00037
更新日期:2000-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-199405000-00017
更新日期:1994-05-01 00:00:00
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doi:10.1097/01.CCM.0000217218.51381.49
更新日期:2006-07-01 00:00:00
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doi:10.1097/00003246-200007000-00035
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To determine the frequency, etiology, and risk factors of ventilator-associated pneumonia (VAP) and purulent tracheobronchitis (TBX) in patients who have undergone heart surgery. To study the predictive role of systematic surveillance cultures. DESIGN:Prospective study. SETTING:Heart surgery intensive care ...
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doi:10.1097/01.ccm.0000084807.15352.93
更新日期:2003-07-01 00:00:00
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doi:10.1097/00003246-200109000-00010
更新日期:2001-09-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198701000-00004
更新日期:1987-01-01 00:00:00
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doi:10.1097/00003246-199401000-00029
更新日期:1994-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-198412000-00014
更新日期:1984-12-01 00:00:00
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pub_type: 杂志文章,meta分析
doi:10.1097/CCM.0b013e31823778ee
更新日期:2012-03-01 00:00:00
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更新日期:2019-05-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2003-04-01 00:00:00
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doi:10.1097/00003246-200001000-00030
更新日期:2000-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-10-01 00:00:00
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journal_title:Critical care medicine
pub_type: 共识发展会议,杂志文章,评审
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更新日期:2005-07-01 00:00:00
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更新日期:2004-06-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2002-07-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-200204000-00005
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To determine the maternal morbidity and mortality in patients with eclampsia admitted to an intensive care unit (ICU), and to establish the efficacy of the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the organ system failure score as defined by Knaus, and the Glasgow Coma Scale (GCS) sco...
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pub_type: 杂志文章
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更新日期:2000-01-01 00:00:00