A statistical model that predicts the length from the left subclavian artery to the celiac axis; towards accurate intra aortic balloon sizing
1 Department of Cardiothoracic Surgery, Royal Victoria Hospital, Belfast, BT12 6BA, UK & Northern Ireland
2 Department of Statistics & Epedemiology University of Patras Medical School, Patras, 26504, Greece
3 Cardiothoracic Department University of Patras Medical School, Patras, 26504, Greece
Journal of Cardiothoracic Surgery 2011, 6:95 doi:10.1186/1749-8090-6-95Published: 9 August 2011
Ideally the length of the Intraaortic balloon membrane (22-27.5 cm) should match to the distance from the left subclavian artery (LSA) to the celiac axis (CA), (LSA - CA). By being able to estimate this distance, better guidance regarding IABP sizing could be recommended.
Internal aortic lengths and demographic values were collected from a series of 40 cadavers during autopsy. External somatometric measurements were also obtained.
There were 23 males and 17 females. The mean age was 73.1+/-13.11 years, weight 56.75+/-12.51 kg and the height 166+/-9.81 cm.
Multiple regression analysis revealed the following predictor variables (R2 > 0.70) for estimating the length from LSA to CA: height (standardized coefficient (SRC) = 0.37, p = 0.004), age (SRC = 0.35, p < 0.001), sex (SRC = 0.21, p = 0.088) and the distance from the jugular notch to trans-pyloric plane (SRC = 0.61, p < 0.001).
Recommendations: If LSA-CA < 21.9 cm use 34 cc IABP & if LSA-CA > 26.3 cm use 50 cc IABP. However if LSA-CA = 21.9- 26.3 cm use 40 cc, but be aware that it could be "aortic length-balloon membrane length" mismatching.
Routinely, IABP size selection is being dictated by the patient's height. Inevitably, this leads to pitfalls. We reported a mathematical model of accurate intraaortic balloon sizing, which is easy to be applied and has a high predictive value.