Use of an intra-aortic balloon pump with chronic renal cardiac surgery.

Abstract

To investigate the protective effect of an intra-aortic balloon pump (IABP) on renal function during open-heart surgery in patients with chronic renal insufficiency. Seventeen patients with moderate renal insufficiency who underwent cardiac pulmonary bypass surgery were randomly assigned to receive either IABP or usual care (control group). In the IABP group, the IABP was inserted immediately after anesthesia, and built-in counterpulsation was continued during aortic blockade. The IABP was gradually removed when postoperative hemodynamics and renal function was recovered. Clinical parameters related to renal function, including urine output and serum creatinine levels, were recorded perioperatively. Urine volume during surgery, postoperative usage of diuretics, and mechanical ventilation time were better in the IABP group than in the control group. Serum creatinine increased after surgery in both groups, but the increase was significantly smaller in the IABP group. Preoperative use of IABP in patients with moderate renal insufficiency undergoing cardiac surgery can help protect renal function and may improve prognosis.