Intra-aortic balloon pump

The
intra-aortic balloon pump (
IABP) is a mechanical device that increases
myocardial oxygen perfusion and indirectly increases
cardiac output through
afterload reduction. It consists of a cylindrical polyurethane balloon that sits in the
aorta, approximately from the left
subclavian artery. The balloon inflates and deflates via counter pulsation, meaning it actively deflates in
systole and inflates in
diastole. Systolic deflation decreases afterload through a vacuum effect and indirectly increases forward flow from the heart. Diastolic inflation increases blood flow to the
coronary arteries via retrograde flow. These actions combine to decrease myocardial oxygen demand and increase myocardial oxygen supply.
A computer-controlled mechanism inflates the balloon with
helium from a cylinder during diastole, usually linked to either an
electrocardiogram (ECG) or a pressure
transducer at the
distal tip of the
catheter; some IABPs, such as the Datascope System 98XT, allow asynchronous counterpulsation at a set rate, though this setting is rarely used. Helium is used to inflate the balloon as its low density means there is little turbulent flow, so the balloon can inflate quickly and deflate slowly. It is also relatively benign and eliminated quickly if there is a leak or rupture in the balloon.
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