Intra-Aortic Balloon Pump

In short, this thing is a catheter with a helium-filled balloon on the end, threaded into one's aorta, rigged to fill and empty in sequence with the cardiac cycle. Yes, it's a very strange thing to have in your aorta. An no, it's not at all uncomfortable - Alex Yartsev

Intra-Aortic Balloon Pump
Intra-Aortic Balloon Pump

image by: IU Health LifeLine

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Another Hole in the Ballon (-Pump)!

In the late 1960's the technology of counter-pulsation by using an intra-aortic balloon pump (IABP) was introduced into clinical work. Based on the principle of diastolic inflation and systolic deflation, IABP counter-pulsation improves diastolic coronary artery blood flow and decreases left ventricular afterload. Up to the year 2009, 2012 respectively, the usage of an IABP in patients with ST-segment elevation myocardial infarction and cardiogenic shock was considered a class IC recommendation (reminder: levels of evidence).

Since then a couple of well conducted, larger trials have failed to show a positive impact of IABP especially on mortality. In regards of the most recent meta-analysis…

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 Another Hole in the Ballon (-Pump)!

Up to the year 2009, 2012 respectively, the usage of an IABP in patients with ST-segment elevation myocardial infarction and cardiogenic shock was considered a class IC recommendation (reminder: levels of evidence). Since then a couple of well conducted, larger trials have failed to show a positive impact of IABP especially on mortality. In regards of the most recent meta-analysis in JAMA we provide a short overview of the most important publications. It's interesting to see that the balloons undermining started with a meta-analysis and for the the time being ends with one.

Life in the Fastlane

The IABP can be used whenever there is cardiac pump failure if: it may resolve spontaneously, or a corrective procedure is planned. In other words, there has to be some hope of the patient being able to survive without an IABP in the future.

StatPearls

Various mechanical circulatory devices have been developed to mitigate the adverse outcomes of cardiogenic shock until treating the underlying cause. To date, four types of mechanical circulatory support devices exist that include Intra-aortic balloon pump (IABP), non-IABP ventricular circulatory assist devices, extracorporeal membrane oxygenation devices, and non-percutaneous ventricular assist devices. Intra-aortic balloon pump is the simplest, cost-effective, easy to implant and explant in the coronary catheterization laboratory by an interventional cardiologist and can effectively be managed in an intensive care unit by an intensivist

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