Observation and nursing of IABP combined with ECMO treatment for patients with low cardiac output syndrome after cardiac surgery

Abstract

Objective To summarize the nursing experience of using intra-aortic balloon counterpulsation (IABP)and extracorporeal membrane oxygenation (ECMO) for patients with low cardiac output syndrome after cardiac surgery.Methods Fourteen patients with postoperative low cardiac output syndrome were treated with IABP and ECMO,and clinical and nursing data was retrospectively analyzed.By observing changes of the parameters of hemodynamics before and after,treatment effect was evaluated and nursing experience was summarized.Results Parameters of hemodynamics improved significantly after combined treatment [SBP:(110.8 ± 11.8) mm Hg / (76.7 ± 18.1) mm Hg; DBP:(60.3 ± 11.2) mmHg / (48.5 ±9.5) mm Hg; LVEF:(0.48 ± 0.02) mmHg / (0.30 ± 0.02)mm Hg],and the differences were statistically significant(t =-5.732,-3.449,-6.192,respectively ;P ＜ 0.05).Index of arterial blood gas also improved [pH:(7.39 ± 0.18) / (7.28 ± 0.08) ; PaO2:(132.02 ± 27.96) mm Hg / (82.71 ± 28.32) mm Hg],and the differences were statistically significant (t =-2.650,-3.690,respectively; P ＜ 0.05).Urine volume with 24 h increased from (1 254.17 ±861.19) ml to(2 588.5 ± 1 360.82) ml,and the difference was statistically significant (t =-3.419,P ＜ 0.05).9 patients were discharged from hospital smoothly.Conclusions IABP combined with ECMO treatment provides an effective option to rescuer patients with low cardiac output syndrome after cardiac operation.Strict monitoring and in-time adjustment of nursing methods are important steps during nursing process. Key words: Intra-aortic balloon counter-pulsation; Extracorporeal membrane oxygenation; Nursing