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Intra-aortic balloon pump diagram

Intra-aortic balloon pump diagram.

About[]

The Intra-aortic balloon pump (IABP) is a mechanical device that is used to decrease myocardial oxygen demand while at the same time increasing cardiac output. By increasing cardiac output it also increases coronary blood flow and therefore myocardial oxygen delivery. It consists of a cylindrical balloon that sits in the aorta and counter-pulsates. That is, it actively deflates in systole increasing forward blood flow by reducing after-load thus, and actively inflates in diastole increasing blood flow to the coronary arteries. These actions have the combined result of decreasing myocardial oxygen demand and increasing myocardial oxygen supply. The balloon is inflated during diastole by a computer controlled mechanism, usually linked to either an ECG or a pressure transducer at the distal tip of the catheter; some IABPs, such as the Data-scope System 98XT, allow for asynchronous counter-pulsation at a set rate, though this setting is rarely used. The computer controls the flow of helium from a cylinder into and out of the balloon. Helium is used because its low viscosity allows it to travel quickly through the long connecting tubes, and has a lower risk of causing a harmful embolism should the balloon rupture while in use.

Pump[]

The actual pump is constructed of a polyethylene balloon mounted on a catheter, which is generally inserted into the aorta through the femoral artery in the leg. The pump is available in a wide range of sizes (2.5 cc to 50 cc) that will fit patients of any age and size. The balloon is guided into the descending aorta, approximately 2 cm from the left subclavian artery. [1]

History[]

Dr. Adrian Kantrowitz introduced the intra-aortic balloon pump (IABP) in the late 1960s as a simple yet effective device to increase coronary perfusion. Because it is easy to insert, the IABP is the most widely used form of mechanical circulatory support. At the Texas Heart Institute, the IABP is now used in more than 450 patients each year.

Although the IABP was first used for surgical patients, the pump can now be used along with interventional cardiology procedures and medical therapy (medications). Indications for its use include:

  • Failure to wean from cardiopulmonary bypass.
  • Cardiogenic shock.
  • Heart failure.
  • Acute heart attack.
  • Support during high-risk percutaneous transluminal coronary (balloon) angioplasty, rotoblator procedures, and coronary stent placement. [2]

Problem Solving[]

A IABP most common problem during preventive maintenance sometimes the balloon can rupture or leak into the catheter, setting off a “failure to inflate” or “low gas” alarm. These balloons should be inspected or replaced as required by the manufacturers recommendation intervals.

Performance Checks[]

  • Balloon cuffs
  • Alarms
  • Knobs
  • Gases - He or CO2 are an inert gas that is easily absorbed into the bloodstream in case of rupture

More reading[]

  1. Counterpulsation: historical background, technical improvements, hemodynamic and metabolic effects," which appears in Volume 84 (1994) of the journal Cardiology (pp. 156-167)

References[]

  1. [1] Texas Heart Institute Journal, Texas Heart Institute, 1996-2010
  2. [2] Texas Heart Institute Journal, Texas Heart Institute, 1996-2010

Links[]

Video[]

thumb|300px|right|IABP Intraaortic Ballon Pump

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