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... [11] Many of the surgically trained PAs worked in the area of cardiothoracic surgery making significant contributions to improved surgical care. [12] Studies confirm the outcomes of task sharing of surgical procedures with physician assistants is comparable to surgeons. A study of Canadian physician assistants compared thoracostomy tube placement in trauma patients with no outcome difference for physician assistants versus trauma surgeons. ...
One hundred thirty eight patients were reviewed which required IABP assist. Sixty nine (84 per cent) of 82 patients who had
been able to come off cardiopulmonary bypass despite increasing pharmacologic support survived operation and 56 patients (68
per cent) discharged hospital. Twenty three (75 per cent) of 31 patients who took for elective coronary artery surgery as
extremely high risk because of extensive three vessel coronary artery disease and severely compromised left ventricular function
discharged hospital. In summary, hospital death was 35 per cent, late death 12 per cent and long term survivors 54 per cent.
Severe complication concerned with inserting balloon catheter occurred in two cases (1.4 per cent) which were abdominal aortic
dissection and laceration of iliac artery. At the present time, the primary indication for IABP is in assistance of the open
heart surgical patient. There are three important factors in successfully managing the patients with IABP. First, begin IABP
assist as soon as possible if indicated. Second, keep an adequate circulating volume with mean left atrial pressure being
maintained around 20 mmHg and cardiac index at 2.1 L/min./M or greater. Third, improve the peripheral vascular circulation,
which might need peripheral vasodilator.
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