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Title: | Does conventional intra-aortic balloon pump trigger timing produce optimal hemodynamic effects in vivo? |
Authors: | Kolyva, C Pantalos, GM Pepper, JR Khir, AW |
Keywords: | intra-aortic balloon pump (IABP);circulatory support;counterpulsation;hemodynamic effects;vivo;assistance frequencies;trigger timings |
Issue Date: | 2015 |
Publisher: | Wichtig Publishing |
Citation: | The International Journal of Artifical Organs, 38(3): pp. 146-153, (2015) |
Abstract: | PURPOSE: The intra-aortic balloon pump (IABP) provides circulatory support through counterpulsation. The hemodynamic effects of the IABP may vary with assisting frequency and depend on IAB inflation/deflation timing. We aimed to assess in vivo the IABP benefits on coronary, aortic, and left ventricular hemodynamics at different assistance frequencies and trigger timings. METHODS: Six healthy, anesthetized, open-chest sheep received IABP support at 5 timing modes (EC, LC, CC, CE, CL, corresponding to early/late/conventional/conventional/conventional inflation and conventional/conventional/conventional/early/late deflation, respectively) with frequency 1:3 and 1:1. Aortic (Qao) and coronary (Qcor) flow, and aortic (Pao) and left ventricular (PLV) pressure were recorded simultaneously, with and without IABP support. Integrating systolic Qao yielded stroke volume (SV). RESULTS: EC at 1:1 produced the lowest end-diastolic Pao (59.5 ± 7.8 mmHg [EC], 63.4 ± 11.1 mmHg [CC]), CC at 1:1 the lowest systolic PLV (69.1 ± 6.5 mmHg [CC], 76.4 ± 6.5 mmHg [control]), CC at 1:1 the highest SV (88.5 ± 34.4 ml [CC], 76.6 ± 31.9 ml [control]) and CC at 1:3 the highest diastolic Qcor (187.2 ± 25.0 ml/min [CC], 149.9 ± 16.6 ml/min [control]). Diastolic Pao augmentation was enhanced by both assistance frequencies alike, and optimal timings were EC for 1:3 (10.4 ± 2.8 mmHg [EC], 6.7 ± 3.8 mmHg [CC]) and CC for 1:1 (10.8 ± 6.7 mmHg [CC], -3.0 ± 3.8 mmHg [control]). CONCLUSIONS: In our experiments, neither a single frequency nor a single inflation/deflation timing, including conventional IAB timing, has shown superiority by uniformly benefiting all studied hemodynamic parameters. A choice of optimal frequency and IAB timing might need to be made based on individual patient hemodynamic needs rather than as a generalized protocol. |
URI: | https://bura.brunel.ac.uk/handle/2438/10457 |
DOI: | https://doi.org/10.5301/ijao.5000385 |
ISSN: | 1724-6040 |
Appears in Collections: | Brunel Institute for Bioengineering (BIB) |
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