ABSTRACT
To assess the efficacy of pharmacological management as compared to early and primary institution of Intra-aortic balloon counterpulsation in the management of low cardiac output syndrome after coronary artery surgery. Postoperative Intensive Care Unit of a tertiary care cardiac hospital. It is a retrospective study of 124 patients who developed post operative low cardiac output syndrome after coronary artery bypass surgery. These patients were treated either with multiple inotropes, plus vasodilators [GP-I, n = 65] or with single inotrope and IABP support within 02 hours after hemodynamic compromise [GP-II, n = 59]. Different hemodynamic variables were compared among both the groups by Statistical Package for Social Sciences [SPSS] Outcome studied: Mean arterial pressure [MAP], Cardiac index [CI], Pulmonary capillary wedge pressure [PCWP], Central venous pressure [CVP], Urine output and ICU stay were compared. Overall survival in both the groups was also noted. Both groups showed improvement in CI, MAP, Urine output, CVP and PCWP, however the improvement was more pronounced in GP-II which was statistically significant after 24 hours. Mean duration of IABP support and stay in ICU was less in GP-II. Survival in GP-I was 24/65 [36.9%] as compared to 34/59 [57.6%] in GP-II. Early initiation of IABP support results in better hemodynamic profile, reduced mortality, reduced ICU stay in patients developing low cardiac output syndrome after coronary artery bypass surgery as compared to pure pharmacologic support or late addition of mechanical support