Perioperative use of the intra-aortic balloon pump: where do we stand in 2018?

Abstract

Purpose of review: Intraaortic balloon pump (IABP) has been the most widely used device to help patients recover from circulatory disorder mainly because of cardiogenic shock; however, no evidence-based clinical benefit derived from IABP support has been reported in recent clinical trials. This review provides an overview of the current outcomes and challenges in perioperative IABP use for cardiogenic shock patients.

Recent findings: Although IABP support yielded no significant difference in mortality for myocardial infarction complicated by cardiogenic shock, perioperative IABP use generated beneficial clinical outcomes for high-risk patients undergoing coronary revascularization. The latest technology such as optical fiber sensor incorporated into the devices provides some beneficial effects on hemodynamics and reduces device-related complications.

Summary: Perioperative IABP use is reasonable for cardiogenic shock patients as a bridge to further surgical intervention, to wean from cardiopulmonary bypass, and to postoperative recovery. Over the next years, a revolutionary technology will overcome the currently limited IABP therapy. Larger and longer term clinical investigations are also required to identify ideal patients for IABP use and to establish the position of IABP therapy.