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Australasian trends in intra-aortic balloon counterpulsation weaning: results of a postal survey

Lewis, Peter A., Mullany, Daniel V., Courtney, Mary D., & Coyer, Fiona M. (2006) Australasian trends in intra-aortic balloon counterpulsation weaning: results of a postal survey. Critical Care and Resuscitation, 8(4), pp. 361-367.

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Abstract

Objective: This study sought to generate baseline data describing Australasian intraaortic balloon counterpulsation (IABP) weaning practice. Methods: A questionnaire survey was mailed to all 192 Australasian intensive care units (ICU). Results: Response rate was 60% (n=116). The majority of hospitals informing practice were government funded public hospitals (65%), had between 100 and 500 beds (69%) and treated a minimum of 11 patients per annum with IABP (60%). The most common method of IABP support withdrawal was ratio reduction only (61%). Units most likely to undertake ratio weaning were higher end users of IABP (>21 per annum) (p=0.04). Other weaning practices involved a combination of ratio followed by volume (17%), volume then ratio (11%) and volume only (4%). Approaching statistical significance, ratio reduction weaning less frequently required IABP reinsertion or inotropic increase post balloon removal (p=0.068). Those units with documented weaning policies were less likely to require reinsertion or inotropic increase post removal (p=0.06). Criteria of importance prior to IABP weaning or removal were: blood pressure (92%); heart rate (76%); pulmonary artery wedge pressure (59%); noradrenaline dose (78%); adrenaline dose (57%); and dobutamine dose (57%). Pharmacologic escalation post balloon removal was reported between 2 and 10% by 90% of units. Balloon reinsertion was 2% or less for 87% of units. Conclusions: The Australasian approach to IABP weaning is eclectic. While ratio reduction weaning appears the most successful manner of support withdrawal, it may be a consequence of a volume outcome relationship with high end users yielding improved results through IABP familiarity.

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ID Code: 6841
Item Type: Journal Article
Additional Information: Self-archiving of the author-version is not yet supported by this publisher. For more information, please refer to the journal’s website (see hypertext link) or contact the author. Author contact details: p.lewis@qut.edu.au
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Keywords: assisted circulation, cardiac output, low, shock, myocardial ischaemia, thoracic surgery, questionnaires
ISSN: 1441-2772
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CARDIOVASCULAR MEDICINE AND HAEMATOLOGY (110200) > Cardiology (incl. Cardiovascular Diseases) (110201)
Divisions: Current > Research Centres > Centre for Health Research
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2006 Australasian Academy of Critical Care Medicine
Deposited On: 04 Apr 2007
Last Modified: 29 Feb 2012 23:27

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