The third Annals of B Pod December Issue highlights a new section - highlighting cases on the front lines in the helicopter. The intra-aortic balloon pump (IABP), first developed in the 1960s, is one of the most widely-used cardiac assist devices. Placed in critically-ill patients with cardiogenic shock, it increases coronary blood flow and decreases afterload. Patients with IABPs are frequently transferred to tertiary referral hospitals via helicopter emergency medical services (HEMS) transport. As such, prehospital and ED providers must become comfortable with the management of these patients and be aware of complications from these devices, we will take a look at two Air Care cases with IABPs.Read More
IABP With Dr. Wojciechowski
- What is it? It's a ~10cm long intravascular balloon that inflates with 25-50ml of helium gas during diastole to increase the coronary perfusion pressure and decrease the afterload on the heart (coronary perfusion pressure = diastolic blood pressure - left ventricular end diastolic blood pressure). The catheter itself has a pressure transducer and a catheter that shuttles the helium gas.
- Why helium? it is low density, metabolically inactive, and dissolves in blood in case the balloon were to rupture.
- Who gets one? In general they are reserved for hemodynamically unstable patients as salvage therapy (STEMI with cardiogenic shock, acute MI that can't be reperfused, high risk CABG, failed maximal medical therapy).