Hemodynamic Effects of Intra - aortic Balloon Pump ( IABP )

Kim, Kwang Min; Kim, Hyun Soo; Oh, Tae Hee

Abstract

Intra-aortic ballon pump(IABP) has been widely used since 1968 when Kantrowitz reported its design and clinical application for the patient with cardiogenic shock. However, information regarding clinical effectiveness of this device in terms of hemodynamic status had been limited. Consequently, using a simple random sampling method we retrospectively selected 23( 65+/-9.7 yr, mean+/-S.D.) out of 223 cases in which IABP had been inserted for a period of 13 months (from September, 1986 through October, 1987) in Yale-New Haven Hospital and evaluated their hemodynamic parameters. Six of 23 cases had IABP inserted in the coronary care units(CCU) and 17 had undergone cardiopulmonary bypass(CPB) for coronary artery bypass graft(CABG) except one case for aneurysmectomy and VSD repair. Nine of these 17 had IABP inserted for improvement of their preoperative cardiovascular functions and eight of then for successful weaning from CPB following CABG. While the diastolic pressure, cardiac output and cardiac index(CI) had increased from 62+/-11.0mmHg, 4.4+/-1.40 I/min, and 2.5+/-0.80 I/min/m2 to 69+/-10.8, 5.1+/-1.34, and 2.8+/-0.83, respectively, pulmonary arterial diastolic pressure(PAD) and pulmonary capillary wedge pressure(PCWP) decreased from 22+/-9.7 and 19+/-4.9 to 20+/-4.5 and 16+/-5.9 mmHg, respectively, after IABP counterpulsation. Despite their poor preoperative hemodynamic function (ASA Class IV or V), 18 out of these 34 (78.3%) had survived during hospitalization. Under the condition of our study IABP appears to be an alternative beneficail therapeutic aid for the patient with cardiogenic shock.