IABP in action

IABP – monitor screenshot

Green tracing: ECG. White tracing: Respiration. Red tracing: Intra arterial blood pressure. Yellow tracing: Pulse oximetry. Displays on right side, from top to bottom: Heart rate, respiratory rate, blood pressure, oxygen saturation (SPO2).

Intra aortic balloon pump (IABP) or intra aortic balloon counterpulsation is used to augment the cardiac output and reduce the afterload to the heart. Classic indication for IABP is cardiogenic shock. It can be either in the setting of acute myocardial infarction, cardiac surgery or in a person undergoing high risk percutaneous coronary intervention. The IABP balloon is inserted through the femoral artery and the balloon positioned below the left subclavian and above the renal arteries. Aortic disease and aortic regurgitation are contra indications for balloon pump insertion. The balloon is inflated in diastole and collapses in systole. Helium is used to rapidly inflate and deflate the balloon synchronized to the cardiac cycle. Synchronization can be done using either the ECG signal or pressure transducer signal. There is a small risk of paraplegia due to injury to main thoracic intercostal vessels supplying the spinal cord. IABP is the classic condition in which diastolic pressure is higher than systolic pressure in a pressure tracing.