1.Outcome of patients using intra-aortic balloon pump undergoing coronary artery bypass grafting
Zhongyuan MA ; Mei ZHANG ; Zonggang ZHANG ; Henian TANG ; Jun LIU
International Journal of Surgery 2013;(1):30-32
Objective To evaluate the outcome of patients using intra-aortic balloon pump IABP undergoing coronary artery bypass grafting and to assess the results.Methods From December 2001 to December 2011,eighty-two consecutive patients,who used IABP undergoing coronary artery bypass grafting were studied.The out-come of early complication,mortality,LVEF were analyzed.Results Fourteen patients died.Forty-three patients,who used IABP,no serious complications (malignant arrhythmia,renal insufficience),preoperative LVEF was (46.0 ± 1.8) %,LVEDD was (66.0 ± 4.1) mm,early postoperative LVEF was (50.0 ± 2.7) %,LVEDD was (53.0 ± 2.8) mm (P < 0.05).Conclusion Use of IABP decreased early mortality,and postopertive respiratory tract infections,renal insufficiency were the main complication.Positive use of IABP postoperatively can decrease early mortality.
2.Role of limited fluid resusciration in treatment of traumatic hemorrhagic shock patients attributable to China Wenchuan earthquake
Shan OU ; Lu LIN ; Leshun ZHOU ; Henian LIU ; Maorong RAN ; Shurong BAI ; Jie NIU
Chinese Journal of Trauma 2008;24(12):1040-1043
Objective To compare the clinical effect and safety of limited fluid resuscitation and aggressive/normotensive fluid resuscitation in treatment of earthquake-induced traumatic hemorrhagic shock patients so as to provide reference for clinical application.Methods A total of 62 patients with traumatic hemorrhagic shock in earthquake were employed and divided randomly into limited fluid resuscitation group(Group Ⅰ,30 patients)and aggressive/normotensive fluid resuscitation group(Group Ⅱ,32 patients).All the patients were resuscitated by using halanted solution and HAES-steril as resuscitanaid resuscitation.Then,surgical hemostasis was carried out and dynamic changes of mean blood pressure(MAP),heart rate and central venous pressure(CVP)observed.The base excess,lactic acid and creatinine were detected at four resuscitation points.Results Before full fluid resuscitation,MAP remained at 50-70 mm Hg and 70-90 mm Hg respectively in both groups.After early resuscitation.heart rate showed significant decrease,while CVP increased(P<0.01)but still changed at normal range.Total transfusion volume in Group Ⅰ was less than that of GroupⅡ(P<0.01).There was no statistical difference upon urine volume(P>0.05).There was statistical difierence upon base excess value after resuscitation within group(P<0.01)but no statistical difference between two groups(P>0.05).After resuscitation,hetic acid level wag obviously reduced in both groups(P<0.01),with more significant change in Group Ⅰ,with statistical difference compared with Group Ⅱ(P<0.01).There showed a significant decrease of creatinine in both groups after resuscitation.with statistical difierence within group (P<0.01)but without statistical difference between two groups(P>0.05).Conclusions Compared with aggressive/normotensive fluid resuscitation,limited fluid resuscitation is a more safe and effective way for fluid resuscitation of traumatic hemorrhagic shock,for it can not only reduce transfusion volume and ameliorate hemodynamic indices,but also can increase oxygen supply,improve microcirculation and protect renal function.