Date Added: 15/09/2017

Date Updated: 15/09/2017

Appropriate use of intra-aortic balloon pumps (IABP)

Specialties: Cardiovascular disease & vascular surgery

Technology Type: Devices

Stage of development: Established

Stage of EAA: Assessment Complete

Description, patients and keywords:

One of the most common methods of haemodynamic support for the failing heart is the insertion of an intra-aortic balloon pump (IABP), which have been in clinical use for over 30 years. The balloon is deflated during systole, reducing the work load of the left ventricle. Cardiac output is increased along with blood flow into the coronary arteries. As the balloon is inflated during diastole the aortic valve is closed and oxygen-rich blood is pushed into the coronary arteries, improving flow to the myocardium. Improved coronary blood flow in addition to increased cardiac output with decreased left ventricular work load may resolve symptoms of cardiogenic shock.

The intra-aortic balloon remains the minimally invasive circulatory assistance device most commonly used by intensivists for cases of acute myocardial infarction complicated by cardiogenic shock. However, current evidence does not support its routine use in the majority of this population. Although this circulatory care device may have short-term beneficial effects on some haemodynamic parameters, it does not impact on the rates of either in-hospital or late survival of patients. Current European guidelines do not support the routine use of IABP and it is recommended only as adjunctive therapy for patients with complications, such as a bridge for surgery.