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《Chinese Circulation Journal》 2014-02
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Effect of Prophylactic Application of Intra-aortic Balloon Pump Before Coronary Artery Bypass Grafting for High Risk Patients by Meta-analysis

MENG Yan-hai;CHANG Qian;WANG Shui-yun;LI Shou-jun;ZHANG Hai-tao;ZHANG Yan-bo;Department of Cardiovascular Surgery,Cardiovascular Institute and Fu Wai Hospital,CAMS and PUMC;  
Objectives: To investigate the effect of prophylactic application of intra-aortic balloon pump(IABP) before coronary artery bypass grafting(CABG) in high risk patients by meta-analysis. Methods: The PubMed, Embase, Cochrane controlled trials register databases, CNKI and VIP databases were searched from the data base establishment to 2013-07. According to Newcastle-Ottawa Scale(NOS), a total of 512 references were cited and 9 articles with 1386 patients were analyzed using Rev Man 5.2 for meta-analysis. The patients were divided into 2 groups, Prophylactic group, n=560 patients with IABP before CABG and Control group, n=826 patients without IABP before CABG. The comparative study was conduct between 2 groups. Results: Compared with Control group, Prophylactic group showed obviously decreased hospital mortality(RR: 0.37, 95%CI 0.22-0.63), postoperative low cardiac output syndrome(RR: 0.40, 95%CI 0.19-0.87) and renal dysfunction(RR: 0.59, 95%CI 0.39-0.90), P0.01, P0.02 and P0.01; significantly shortened ICU time(SMD:-0.72, 95%CI-1.13~-0.31, P0.01) and hospitalization time(SMD:-0.34, 95%CI-0.68~-0.01, P=0.04). The incidence of postoperative myocardial infarction(RR: 0.88, 95%CI 0.66-1.18, P=0.04) and neurological complication(RR: 1.05, 95%CI 0.59-1.86, P=0.86) were similar between 2 groups. Conclusion: Prophylactic IABP application before CABG might be safe and effective, it may improve the cardiac function, decrease the postoperative low cardiac output and renal insufficiency, therefore reduce the peri-operative mortality in the high risk patients.
【Fund】: 中央级公益性科研院所基本科研基金(2012F-015);; 中华医学会胸心血管外科分会厄尔巴肯科研奖学金(2011-H28#)
【CateGory Index】: R654.2
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