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Intra-aortic balloon counterpulsation in the ICU 

Intra-aortic balloon counterpulsation in the ICU
Intra-aortic balloon counterpulsation in the ICU

Alain Combes

and Nicolas Bréchot

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date: 01 July 2022

The intra-aortic balloon pump (IABP) is a mechanical device consisting of a cylindrical polyethylene balloon that sits in the aorta, approximately 2 cm from the left subclavian artery. A computer-controlled console linked to either an electrocardiogramor a pressure transducer inflates the balloon with helium during diastole (counterpulsation) and actively deflates in systole. This results in an increase in coronary artery blood flow and cardiac output, and reduced left ventricular afterload. These actions combine to decrease myocardial oxygen demand and increase supply. Major complications include bleeding at the insertion site and retroperitoneal haemorrhage, critical ischaemia of the catheterized leg, catheter infection, and stroke. IABP duration usually varies from 48 to 72 hours. Weaning from IABP is not well defined; the most common approach is to reduce cycling of inflation to 1:2 or 1:4 for 15 minutes to several hours before device removal.

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