Intra-Aortic Balloon Pump Insertion and Management

  • Fernando FleischmanEmail author
  • John David Cleveland


  • Intra-aortic balloon pump (IABP) counterpulsation is a useful circulatory support adjunct in the setting of refractory cardiogenic shock in critically ill patients. The IABP increases myocardial oxygen perfusion and increases the cardiac output.

  • The IABP inflates in diastole, increasing blood flow to the coronary arteries. It deflates in systole decreasing afterload (Fig. 18.1).

  • Indications for placement include coronary ischemia, acute mitral regurgitation, severe myocardial contusion, and cardiomyopathy (of multiple etiologies) resulting in refractory cardiogenic shock despite adequate vasopressor support.

  • Absolute contraindications include existing aortic injury (i.e., dissection) or severe aortic insufficiency.

  • Site of insertion is primarily the common femoral artery although axillary/subclavian and direct aortic arterial access are feasible.

  • Weaning IABP should be performed with the aid of a method to assess cardiac function in addition to systemic blood pressure.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Cardiothoracic SurgeryUSC, School of MedicineLos AngelesUSA

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