The Optimal Weaning Strategy for Intraaortic Balloon Counterpulsation: Volume-Based Versus Rate-Based Approach in an Animal Model Sandro Gelsomino, MD,

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The Optimal Weaning Strategy for Intraaortic Balloon Counterpulsation: Volume-Based Versus Rate-Based Approach in an Animal Model Sandro Gelsomino, MD, PhD, Pieter W.J. Lozekoot, MD, Roberto Lorusso, MD, PhD, Monique J. de Jong, Orlando Parise, MS, Francesco Matteucci, MD, Fabiana Lucà, MD, FESC, Narendra Kumar, MD, Mario Romano, PhD, Gian Franco Gensini, MD, Mark La Meir, MD, PhD, Jos G. Maessen, MD, PhD The Annals of Thoracic Surgery Volume 101, Issue 4, Pages 1485-1493 (April 2016) DOI: 10.1016/j.athoracsur.2015.10.010 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Experimental timeline. (IABP = intraaortic balloon pump.) The Annals of Thoracic Surgery 2016 101, 1485-1493DOI: (10.1016/j.athoracsur.2015.10.010) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Hemodynamics of rate-based (black boxes) and volume-based (gray boxes) intraaortic balloon pump (IABP) withdrawal. (A) Cardiac output (CO). (B). Stroke volume (SV). (C) Cardiac cycle efficiency (CCE). (D) dP/dTmax. (E) Systemic vascular resistance (SVR). (F) Central venous pressure (CVP). The horizontal line in the middle of each box indicates the median; the top and bottom borders of the box mark the 75th and 25th percentiles, respectively, and the whiskers mark the 90th and 10th percentiles. (∗ = significance rate based vs volume based.) The Annals of Thoracic Surgery 2016 101, 1485-1493DOI: (10.1016/j.athoracsur.2015.10.010) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Coronary circulation and metabolism during rate-based (black boxes) and volume-based (gray boxes) intraaortic balloon pump (IABP) withdrawal. (A) Diastolic coronary blood flow (CBFdia). (B) Systolic coronary blood flow (SBFdia). (C) Cardiac resistances (CR). (D) Cardiac oxygen consumption (COC). The horizontal line in the middle of each box indicates the median; the top and bottom borders of the box mark the 75th and 25th percentiles, respectively, and the whiskers mark the 90th and 10th percentiles. (∗ = significance rate based vs volume based.) The Annals of Thoracic Surgery 2016 101, 1485-1493DOI: (10.1016/j.athoracsur.2015.10.010) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Visceral flows during rate-based (black boxes) and volume-based (gray boxes) intraaortic balloon pump (IABP) withdrawal. (A) Systolic mesenteric blood flow (MBFsys). (B) Diastolic mesenteric blood flow (MBFdia). (C) Systolic left renal blood flow (LRBFsys). (D) Diastolic left renal blood flow (LRBFdia). (E) Systolic right renal blood flow (RRBFsys). (F) Diastolic right renal blood flow (RRBFdia). The horizontal line in the middle of each box indicates the median; the top and bottom borders of the box mark the 75th and 25th percentiles, respectively, and the whiskers mark the 90th and 10th percentiles. (∗ = significance rate based vs volume based.) The Annals of Thoracic Surgery 2016 101, 1485-1493DOI: (10.1016/j.athoracsur.2015.10.010) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Biochemical markers during rate-based (black boxes) and volume-based (gray boxes) intraaortic balloon pump (IABP) withdrawal. (A) Troponin. (B) Lactates. The horizontal line in the middle of each box indicates the median; the top and bottom borders of the box mark the 75th and 25th percentiles, respectively, and the whiskers mark the 90th and 10th percentiles. (∗ = significance rate based vs volume based.) The Annals of Thoracic Surgery 2016 101, 1485-1493DOI: (10.1016/j.athoracsur.2015.10.010) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions