Duration of intra-aortic balloon pump use and related complications

Abstract

Background: Intra-aortic balloon pump (IABP) use may be associated with complications; however, in certain patients with ST-elevation myocardial infarction (STEMI) with hemodynamic instability refractory to medical management its use may become necessary.

Methods: 36 STEMI patients with IABP placement for hemodynamic instability after percutaneous coronary intervention were studied. IABP duration ranged from one to seven days (median two days). Based on median time, patients were divided into two groups: IABP duration ≤ 2 days (n = 27) or > 2 days (n = 9). Vascular complications and incidence of bleeding were compared.

Results: Mean IABP duration was 1.4 ± 0.5 and 4.1 ± 1.3 days in ≤ 2 day and > 2 day groups, respectively (P < 0.01). Glycoprotein IIb/IIIa inhibitor and anti-coagulation use was not significantly different between groups. Mean duration of anti-coagulation was 1.9 ± 1.2 and 4.5 ± 1.3 days in ≤ 2 day and > 2 day groups, respectively (P < 0.05). Complications (vascular, access site bleeding, gastrointestinal bleeding) were significantly greater in > 2 day group (66%) compared to ≤ 2 day group (18%; P < 0.05).

Conclusions: When an IABP was used for more than two days complications significantly increased. The clinical implications of the study will be strengthened if the findings are confirmed in a prospective study with a larger number of patients.