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Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(1):24-28; doi:10.1093/bjaceaccp/mkn051
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© The Board of Management and Trustees of the British Journal of Anaesthesia [2009]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Principles of intra-aortic balloon pump counterpulsation

Murli Krishna, MBBS FRCA FFPMRCA
Consultant in Anaesthetics & Pain Medicine
Frenchay Hospital
Bristol BS16 1LE, UK
E-mail: drmkrish@gmail.com

Kai Zacharowski, MD PhD FRCA
Chair of Cardiovascular Anaesthesia and Critical Care
Consultant in Anaesthesia and Critical Care
Department of Anaesthesia
Bristol Royal Infirmary
Bristol BS2 8HW, UK
Tel: +44 117 928 2301/2365 Fax: +44 117 926 8674 E-mail: kai.zacharowski@bristol.ac.uk

The first 150 words of the full text of this article appear below.


Key points

The primary goal of intra-aortic balloon pump (IABP) treatment is to increase myocardial oxygen supply and decrease myocardial oxygen demand.
Decreased urine output after the insertion of IABP can occur because of juxta-renal balloon positioning.
Haemolysis from mechanical damage to red blood cells can reduce the haematocrit by up to 5%.
Suboptimal timing of inflation and deflation of the balloon produces haemodynamic instability.
An IABP is thrombogenic; always anticoagulate the patient.
Never switch the balloon off while in situ.

 

Intra-aortic balloon pump (IABP) remains the most widely used circulatory assist device in critically ill patients with cardiac disease. The National Centre of Health Statistics estimated that IABP was used in 42 000 patients in the USA in 2002. Advances in technology, including percutaneous insertion, smaller diameter catheters, sheathless insertion techniques, and enhanced automation, have permitted the use of counterpulsation in a variety of settings, with greater efficacy and . . . [Full Text of this Article]


   History
 

   Basic principles of counterpulsation
 

   Physiological effects of IABP therapy
 
Myocardial oxygen supply and demand

Coronary perfusion

Renal function

Haematological effects


   Indications
 
Acute myocardial infarction

Ventricular arrhythmias

Cardiogenic shock

Unstable angina

Refractory ventricular failure

Cardiac surgery


   Contraindications
 

   Technique of insertion and operation
 

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