Intraaortic Balloon Pump (IABP)

Major hemodynamic effects:

o Blood is displaced to the proximal aorta by inflation during diastole

o Afterload is reduced during systole through a vacuum effect of balloon deflation

o There is an overall decrease in systolic pressure by 20 %

o There is an overall increase in diastolic pressure by 30 % (may improve coronary blood flow in critical stenosis)

o There is a reduction of the heart rate by less than 20%

o A decrease in the mean pulmonary capillary wedge pressure by 20%

o An elevation in the cardiac output by 20 %

Main indications for placement of IABP:

• Cardiogenic shock that is not quickly reversed with pharmacologic therapy
• Hypotension that is not responsive to other interventions
• A low output state.
• Acute mitral regurgitation, particularly due to papillary muscle rupture, or ventricular septal rupture
• Recurrent ischemic chest pain, with signs of hemodynamic instabilit

 

• Significant aortic regurgitation
• Abdominal aortic aneurysm or aortic dissection
• Uncontrolled sepsis
• Uncontrolled bleeding disorder
• Severe bilateral peripheral vascular disease
• Bilateral femoral popliteal bypass grafts for severe peripheral vascular disease

(Victoria Kelly MD, 11/29/10)