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Objective:To explore the safety and effect of intra-aortic balloon counterpulsation (IABP) combined non-invasive ventilator on recent curative effect in patients with acute myocardial infarction (AMI) complicated pump failure after emergency percutaneous coronary intervention (PCI) .Methods:A total of 105 patients ,who hospital-ized in our CCU because of AMI complicated pump failure from Jul 2012 to Jun 2014 ,were selected .They were di-vided into IABP group (n=68 ,received IABP and noninvasive ventilator based on routine treatment ) and routine treatment group (n=37 ,received routine treatment and noninvasive ventilator therapy ) ,and all patients received e-mergency coronary angiography ,PCI and medication etc .Changes of blood pressure ,heart rate ,urine volume , echocardiography and brain natriuretic peptide (BNP) level etc .,and incidence of complications and cardiac adverse events were observed and compared between two groups during hospitalization . Results:Compared with routine treatment group during hospitalization ,blood pressure significantly rose and heart rate gradually declined to stable ;there was significant rise in left ventricular ejection fraction [(35 ± 9)% vs .(37 ± 10)% ] ,and significant reductions in BNP level [ (467 ± 197) pmol/L vs .(236 ± 146) pmol/L] ,mortality rate (28.9% vs .19.1% ) and hospital stay [ (16.2 ± 4.1) d vs .(11.6 ± 3.4) d] in IABP group , P<0.05~ <0.01 .Conclusion:IABP combined noninvasive ventilator can effectively improve patient′s condition ,stabilize hemodynamic status , reduce in-hospital mortality rate and gain time for further therapy to improve prognosis in patients with AMI complicated pump failure .
ABSTRACT
<p><b>BACKGROUND</b>To evaluate the clinical significance of predicting post-operative respiratory failure in patients with lung cancer using cardiopulmonary exercise test (CPET).</p><p><b>METHODS</b>Before operation, 260 patients with lung cancer underwent CPET with incremental protocol. W%, VO₂%P, VO₂/kg, AT, MET, O₂ pulse, VTe, BF and VE were measured in the end of load exercise.</p><p><b>RESULTS</b>(1) In patients after pneumonectomy, the values of the above indexes of CPET in the respiratory failure group were significantly lower than those in the non-respiratory failure group ( P < 0.05 or P < 0.01) except VTe. In patients after lobectomy, the values of 9 indexes of CPET in the respiratory failure group were similar to those in the non-respiratory failure group ( P > 0.05). However, when the patients after lobectomy were further divided into groups of upper and lower lobectomy, W% in the respiratory failure group was remarkably lower than that in the non-respiratory failure group after lower lobectomy ( P < 0.05). (2) Chi-Square test showed that abnormality of CPET indexes in different degrees was related to the morbidity of respiratory failure after pneumonectomy. Logistic regression showed that O₂ pulse < 80% and BF < 30/min correlated with the morbidity of post-operative respiratory failure. (3) For predicting post-operative respiratory failure, the sensitivity and specificity of VO₂%P < 60%, BF < 30/min, VE < 35 L/min were all more than 60% and their negative predictive values were all more than 90%.</p><p><b>CONCLUSIONS</b>CPET is suitable to predict post-pneumonectomy respiratory failure. As a comprehensive index indicating cardiopulmonary function during exercise, VO₂%P < 60% should be selected to predict respiratory failure and evaluate indication of lung resection for patients with lung cancer.</p>
ABSTRACT
<p><b>BACKGROUND</b>To explore the characteristics of exercise cardio-pulmonary function and its possible influencing factors in patients with lung cancer.</p><p><b>METHODS</b>The pulmonary function, ECG and exercise cardio-pulmonary function were measured in 198 patients with lung cancer and 20 healthy controls.</p><p><b>RESULTS</b>1. Compared with healthy group, VO₂%P, VO₂/kg, AT, VO₂/HR%, VE and VT/VC significantly decreased in lung cancer patients with normal resting pulmonary ventilation, however, BR remarkably increased (P < 0.05 or P < 0.01). 2. In patients with normal resting pulmonary ventilation, there was no significant difference of exercise cardio-pulmonary function between the central and peripheral lung cancer groups. 3. The exercise cardio-pulmonary function was closely related to the TNM stages (P < 0.05 or P < 0.01). 4. W%, VO₂%P , AT and VO₂/HR% in patients with great vessel invasion were remarkably lower than those without great vessel invasion (P < 0.05 or P < 0.01).</p><p><b>CONCLUSIONS</b>The results suggest that exercise ventilation is impaired in lung cancer patients with normal resting ventilation. And the decrease of exercise cardio-pulmonary function may be related to TNM stage and to great vessel involvement.</p>