Intra-Aortic Balloon Pump

Excerpt

Patients with the clinical and biochemical signs and symptoms of hypoperfusion secondary to cardiac failure or cardiac arrest carry high short-term mortality. 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. Although IABP has a modest hemodynamic beneficial effect compared with novel, advanced mechanical circulatory support devices, it has a better safety profile, relative simplicity to use, and the beneficial cardiovascular physiological impact. These features make IABP a frequently used circulatory support device in patients requiring hemodynamic support either in cardiogenic shock or at risk of hemodynamic decompensation during a high-risk coronary intervention. However, currently available evidence related to the use of IABP is in constant flux. Therefore, it is important to review the safety and efficacy of IABP in various clinical conditions and appraise the health care providers of current evidence-based literature related to IABP. This article reviews the physiological and hemodynamic effects of IABP on the cardiovascular system as well as the safety and efficacy of its use in various cardiovascular clinical conditions.