In resource-limited settings, IABP therapy serves as a viable temporary mechanical circulatory support strategy to bridge critically ill patients, particularly those with AMI and cardiogenic shock, to care escalation at tertiary centers.
Despite providing relatively modest circulatory support, the intra-aortic balloon pump (IABP) remains the most utilized mechanical support device. IABP therapy specifically provides utility in transferring critically ill patients from resource-limited hospital settings. In a single-center series, 71 patients who received IABP were identified from 2018 to 2023. In this group, 66 (93%) patients presented with acute myocardial infarction (AMI), of which 40 (61%) patients presented with STEMI. Sixty-three (89%) patients presented in cardiogenic shock. In total, 15 (21%) patients died during their hospital stay. In-hospital death was found to be associated with higher age (p < 0.001), female sex (p = 0.004), and chronic heart failure (p = 0.009). Serologic markers of end-organ perfusion, such as lactate, creatinine, and hepatic enzymes, were associated with increased mortality risk. Thirty (41%) patients were successfully transferred to a hub institution for care escalation, including 17 (57%) patients receiving cardiac surgery, five (17%) receiving advanced PCI, and 12 (40%) receiving more robust mechanical support. Therefore, in the real-world setting, IABP therapy provides an accessible form of circulatory support at resource-limited institutions, especially when patient transfer is required within a larger hospital system.
Patil et al. (Mon,) studied this question.