How does Intra-Aortic Balloon Pump (IABP) Work? | What is Intra-Aortic Balloon Pump Therapy?

An intra-aortic balloon pump (IABP) helps your heart pump more blood. It is one of the most famous types of therapeutic devices. You may need this pump if your heart can’t pump sufficient blood for your body. This article explains intra-aortic balloon pump therapy risks, uses, and advantages.

What is an Intra-aortic Balloon Pump?

An intra-aortic balloon pump (IABP) is a medical device used to help the heart in pumping blood. This is a mechanical device that is inserted through a major blood vessel, such as the femoral artery in the groin, and advanced into the aorta, which is the main artery that carries blood from the heart to the rest of the body.

An intra-aortic pump is made up of a balloon located in the aorta (the largest vessel and main artery in the human body, located just below the heart). As the heart ventricles tighten and release the blood, then IABP deflates. This pump reduces resistance (afterload) behind the heart and increases blood flow forward.   

As the ventricle of the heart loosens (diastole) and fills with blood again, the pump actively expands and increases the flow of blood to the coronary arteries (the arteries that supply O2 to the heart). Combining these actions reduces the heart’s need for oxygen and improves the O2 delivery to the heart.

intra-aortic balloon pump (IABP)

During the working, the intra-aortic balloon pump balloon expands and depresses due to the reverse pulsation process. In simple words, it inflates during diastole and depresses aggressively during systole. With the help of the vacuum effect, systolic deflation reduces the afterload and indirectly improves the anterior blood flow to the heart.

The pump inflates during the diastole process and boosts the coronary arteries’ blood flow through the retrograde blood flow. Together, these processes (systolic and diastole) reduce myocardial O2 need and increase myocardial O2 (oxygen) delivery.

An intra-aortic balloon pump has a flexible, thin tube known as a catheter. A long balloon is attached to the catheter tip. This is known as an IAB (intra-aortic balloon).

A computer console is linked to the other side of the catheter. This console is equipment that inflates and depresses the balloon according to the heartbeat.

In this pump, Helium is used to inflate a balloon. Therefore, the balloon can inflate quickly and depress gradually. If the balloon breaks or leaks then the Helium can also dislodge rapidly.

How does an Intra-aortic Balloon Pump Work?

The heart delivers nutrients and oxygen-rich blood to all parts of your body. The arteries are utilized to discharge the blood from the heart and deliver the oxygen-rich blood to blood vessels.

Your heart gets nutrients and O2 from blood vessels according to its need. There are also arteries in the heart’s outer wall that are known as coronary arteries.

As your heart deflates, it pumps blood to your body. When it is relaxed, blood moves inside the coronary arteries and carries O2 to the heart. The intra-aortic balloon pump helps blood to move quickly to the coronary arteries.

This pump also assists the heart to supply more blood with each contraction. However, it only improves the functionality of the left ventricle. This is because the left ventricle is the chamber that supplies blood to the aorta of your body.

intra-aortic balloon pump working

An intra-aortic balloon pump works in the following way:

  • First of all, you need to insert the balloon into the aorta. The aorta is a lengthy artery that begins from the heart. Sometimes, this process also performs through a small incision on the inner side of the upper leg.
  • Next, the doctor will require to insert a balloon pump catheter into the leg artery. After this, the doctor needs to bring it to your aorta.
  • After inserting the IABP, it will start working. When your heart relaxes, the balloon inflates. In such conditions, it forces the blood back into the coronary arteries. These arteries can’t get adequate blood without a pump.
  • When your heart shrinks, the balloon also shrinks. This shrinkage generates additional room in the aorta, which allows the heart to pump more blood. This process will reduce the stress on your heart. The pump will continue to expand and contract until it eliminates.

To properly understand the working of IABP, watch the following video: –

Components of IABP

An intra-aortic balloon pump has the following components:

  • Ballon
  • IABP Console 
  • Catheter 
  • Transducer

components of Intra-aortic balloon pump

1) Balloon

The balloon is used to block the way of blood in the aorta at a specific point in time. That means it must be able to resist the pressure of the heart.

It is made of a material that will not break or damage easily. This component of the intra-aortic balloon pump should be biocompatible.

2) IABP Console

The IABP console is a monitoring machine. It is the source of gas for the IABP. This component is necessary to deflate and inflate the balloon properly.

It is also compulsory for the monitoring systems so that the monitoring system can also determine what stage the balloon is in so that it doesn’t expand at the wrong time and cause problems.

This monitoring device uses an ECG (electrocardiogram) to regulate the stage of the heart. It uses helium to inflate the balloon as the aortic valve shuts and cardiac output and heart pressure increase.

3) Catheter

This component attaches the balloon with a transducer (outside the body) and a monitoring device (inside the aorta). It is a flexible tube that can insert into the body’s narrow opening. It uses to withdraw or introduce fluid.

4) Transducer

During the first test in 1962, the transducer was integrated into the IABP design. Its purpose was to transform signal or energy from one format to another and display it on a monitor for clarification.

A transducer is compulsory for continuous blood pressure monitoring because the IABP uses a double notch in the aortic blood pressure curve to measure the time of expansion and contraction of the balloon.

How to prepare yourself for intra-aortic balloon pump therapy?

Before the treatment, you must talk with your healthcare provider. Your healthcare provider will provide detailed directions about your treatment.

If you are pregnant or suspect you may be pregnant, be sure to tell your doctor. And also, tell him/her if you are facing:

  • Sedation problems
  • New symptoms like an unexpected fever
  • Any other diseases

Following are some instructions that you should follow for your intra-aortic pump therapy:

  • If you are a smoker, then you must stop smoking before the treatment. This can decrease the likelihood of complications.
  • You should also stop the use of medicine before the treatment. Sometimes, you may be needed to take medicine before and during therapy to stop blood clots.
  • Don’t drink or eat after 12 AM before the day of surgery.

Some other tests may require measuring your health beforehand. These can include:

  • Echocardiography (uses to check your heartbeat)
  • Basic blood test (assessment of anemia and infectious diseases)
  • Chest X-ray (uses to see the lungs and heart)
  • Electrocardiogram (uses to check heart rate)

What happens during intra-aortic balloon pump therapy?

In intra-aortic balloon pump therapy, a balloon-tipped catheter is inserted inside a vessel of the blood which advanced to the heart. This process usually adopts during heart-related surgery. However, in emergencies, the medical team can put it at the bedside.

Your doctor can let you know exactly what will happen. In general, this treatment consists of the below-given steps:

  • Firstly, you may get a few shocks. If this is inserted during your operation, then you are already facing the shocks. In such a condition, you may fall asleep without feeling anything. During other conditions, you will get relaxation medication that will be helpful for you.
  • Your heart rate, blood pressure, and other vital signs will also be monitored throughout the surgery.
  • A small incision will be generated through the artery in your inner thigh’s upper section. Insert a balloon catheter there.
  • The surgeon advances the catheter up to part of the aorta in the chest. This movement may monitor through a continuous X-ray image.
  • When the IABP is inserted properly, the balloon will also start to inflate as the heart relaxes. When the heart contracts then the balloon also contracts.
  • The catheter’s end is a secure place; therefore, the balloon will place there.

Your chest may hurt a little after the operation. It may go away within a few minutes of starting the IABP. However, further treatment may be required if symptoms persist.

After the intra-aortic balloon pump therapy, you need to adopt the following precautions: 

  • Your doctor will be there if you will face any problems.
  • You will need to rest in bed for some time.
  • Raise the head of the bed a little bit.
  • Keep the leg into the catheter insertion and keep it straight. This will prevent the balloon from moving in place.
  • A daily chest X-ray may require to make sure that the balloon is in its proper position. Pumps often make noise by expanding and contracting repeatedly.

What happens after intra-aortic balloon pump therapy?

You may need to keep the pump “ON” for many days. Your doctor will continuously observe this. Your healthcare provider can temporarily stop the balloon pump to see your reaction after turning it off. Alternatively, your doctor can customize your pump up so that it only expands and contracts with every 3 or 5 heartbeats.

If your heart starts to pump blood on its own without a balloon, you should stop the intra-aortic balloon pump treatment. Treatment can also be stopped if other interventions are accessible (e.g., heart donation).

If you need to remove the balloon, you may be given relaxation medication. Then the doctor will eliminate the catheter and the balloon connected to it. The doctor also closes the cut in your leg during the pump elimination.

The doctor may hand you some more instructions about the expected result. If you will obey them gently, you will increase the likelihood of positive results.

How to use Intra-aortic Balloon Pump

An IABP (intra-aortic balloon pump) is a balloon pump that is designed for people who have severe heart problems (such as congestive heart failure and heart attack, etc.) or are expecting a heart transplant.

This procedure needs the settlement of a catheter with the intra-aortic balloon.

The balloon of the intra-aortic pump inserts into the body’s artery, typically into the groin and then into the aorta (the body’s largest artery).

Now, connect the catheter to a computer that monitors the deflation and inflation, pressure, and time for the balloon to inflate as the heart muscle relaxes and contracts before the heart pumps blood again. This procedure is known as “counterpulsation”. This will help your mind in the following ways:

When the heart relaxes, a pump at your bedside inflates the aortic balloon so that oxygen-rich blood can easily reach the heart. The pump then deflates the balloon just before the heart is ready to pump this oxygen-rich blood. This reduces the pressure in the aorta and helps the heart to move blood around the body more easily.

As the heart is stable and able to work normally, remove the IABP and catheter and apply pressure to stop the bleeding.

Advantages of Balloon Pump

  • An IABP permits blood to move more easily into the coronary arteries.
  • It helps your heart pump more blood with each contraction.
  • It boosts diastolic coronary
  • This device also rises the systemic flow of the blood
  • It reduces afterload and myocardial work

FAQ Section

What is the Purpose of Intra-aortic Balloon Pump (IABP) therapy?

An intra-aortic balloon pump (IABP) therapy has the following major purposes:

  • This treatment uses to boost myocardial oxygen delivery
  • It uses to reduce the myocardial oxygen need
  • It increases the pressure of coronary perfusion
  • Improve the cardiac output (CO)

Who invented Intra-aortic Balloon Pump?

Numerous anecdotal tried to develop IABP for a long time but the first IABP was developed in the 1950s.  In 1960, Kantrowitz clinically launched the first intra-aortic balloon pump.

What are the risks of Intra-aortic Balloon Pump Therapy?

Treatment with IABP is beneficial. Sometimes it even saves lives. But the intra-aortic balloon pump therapy also has the following risks:  

  • Infection due to insufficient blood supply to the limb (ischemia)
  • Arterial injury
  • Due to the low platelet count, the blood does not clot and may cause excessive bleeding.
  • Balloon explosion
  • Infections
  • Sometimes, the balloon doesn’t locate at its correct position or may change position inside the body; due to that patient may face kidney damage or other issues.
  • Treatment with IABP is uncomfortable. Therefore, if you install this device, you should calmly lie down on the hospital bed.
  • Heart strokes
  • The intra-aortic balloon pump can produce some side effects. For example, long-term use of IABP can create bloodstream infections. It can also produce blood clots and lead to severe issues like stroke. Sometimes, the balloon can become over-inflated, due to which the aorta ruptures.

The risks of this device depend on the patient’s age and other medical situations that a patient has

What is an intra-aortic balloon pump used for?

Intra-aortic balloon pump is used to assist the heart to pump more blood. You can use it if your heart is not properly pumping blood to your body. 

How long can you have an intra-aortic balloon pump?

Although an intra-aortic balloon pump (IABP) is typically used for a short period of time, usually less than a week, there may be cases where it needs to remain in place for an extended period. In some situations, a healthcare provider may keep the IABP in place for up to 30 days or longer, depending on the patient’s condition and response to treatment.

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