easy guide to IABP

1. Intraaortic balloon
pump
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3. IABP needs your help!
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https://www.carstuff.com.tw/car-news/item/20064-2016-05-31-07-05-15.html

4. History of IABP
• Preliminary studies since 1961
• First successful treatment in 1967
– 45 y/o male with MI and cardiogenic shock, performed by Kantrowitz
• First preoperative application for CABG in
1970
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5. History of IABP
• Assist in difficult weaning from CPB in
1973.
– 1976 more than 5000 patients with post-cardiotomy low cardiac output
had received IABP treatment in United States
– most widely used cardiac support devices with an annual estimate of
200 000 IABPs placed worldwide
• Continuous evolution
– percutaneous insertion without the need for surgical cut down
– optimal timing of counterpulsation and on-line monitoring
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Alaour B. and English W. Intra-Aortic Balloon Pump Counterpulsation. Anaesthesia Tutorial of the Week.

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Alaour B. and English W. Intra-Aortic Balloon Pump Counterpulsation. Anaesthesia Tutorial of the Week, 2011.

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Alaour B. and English W. Intra-Aortic Balloon Pump Counterpulsation. Anaesthesia Tutorial of the Week, 2011.

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http://www.icid.salisbury.nhs.uk/CLINICALMANAGEMENT/CARDIOVASCULAR/Pages/Intra-aorticBalloonPump-PatientManagement.aspx

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Seminars in Cardiothoracic and Vascular Anesthesia 2015, Vol. 19(2) 106–121

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Anesth Analg. 2011 Jul;113(1):40-3

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Anesth Analg. 2011 Jul;113(1):40-3

14. Circuit of IABP
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Parissis et al. Journal of Cardiothoracic Surgery (2016) 11:122
(Helium or CO2)

15. Balloon catheters /sizing
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16. Balloon catheters /sizing
• Length from the left Subclavian artery to
the coeliac artery
• Inflated diameter : 90 to 95 % of
discending aorta
• Balloon end should be lying above the
renal vessels
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17. Physiological effects of IABP
• Increases coronary artery perfusion
– Increases myocardial oxygen supply
• Decreases myocardial oxygen demand
– Decreases myocardial work by reducing
afterload
• Increases blood pressure
• Decreases pulmonary artery pressure
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18. Physiological effects of IABP
• Increased cerebral blood flow
• Increased renal blood flow
– appropriate IABP position
– No complication
• Hematological Effects
– mild thrombocytopenia
– hemolytic anemia
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Alaour B. and English W. Intra-Aortic Balloon Pump Counterpulsation. Anaesthesia Tutorial of the Week, 2011.

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Semin Cardiothorac Vasc Anesth. 2015 Jun;19(2):106-21

23. Datascope 98XT
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24. Datascope 98XT
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25. Trigger
• ECG
– trigger on the patient’s R-wave
• Pressure
– Useful for electro-surgical noise interference
• Internal
– For cardiac arrest or during CPCR
– 40~120 BPM
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26. Trigger
• Pacer V/A-V
– patient must be 100% paced and captured
– automatically suspends pumping in electro-
surgical noise interference
• Pacer A
– trigger on the patient’s R-wave
– only if atrial pacer tails interfere with R-wave
detection when using the ECG trigger mode
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27. Inflation / deflation
• Manually adjust timing of inflation /
deflation
• Deflation slider in the extreme right
position
– In ECG or pacer A trigger mode: R-wave
deflation mode
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28. Auxiliary Keys
• ECG GAIN
• INTERNAL RATE
– Default 80 BPM
– 40~120 BPM
• NORMAL
– Restore default setting
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29. Override key
• R-TRAC
– automatically track changes in patient heart
rate or rhythm
– R-Wave deflation when arrhythmia
– Set to off : prohibited from automatically
selecting the R-wave deflation timing
• Slow gas
– continues to operate even when a small gas
loss is detected
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30. Datascope CS100
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Semin Cardiothorac Vasc Anesth. 2015 Jun;19(2):106-21

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Alaour B. and English W. Intra-Aortic Balloon Pump Counterpulsation. Anaesthesia Tutorial of the Week, 2011.

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