Key result
IABP remains a key mechanical support device for ADHF-CS and AMI mechanical complications.
Why the study?
More than 50 years after its invention, an updated appraisal of the role of the intra-aortic balloon pump in current clinical practice was needed.
This review provides an updated, pragmatic guide to the pathophysiology, clinical use, insertion, and synchronization of the intra-aortic balloon pump in modern critical care.
Remains relevant for ADHF-CS and AMI complications; leaves open comparative efficacy versus newer MCS devices.
PURPOSE OF REVIEW: After more than 50 years from its invention, the intra-aortic balloon pump (IABP) is still one of the most widely used mechanical circulatory support devices to treat cardiogenic shock (CS). This review aims to describe the role of IABP in current clinical practice. RECENT FINDINGS: In recent years the better understanding of the variable hemodynamic profiles that characterize the CS condition has led to a reappraisal of the IABP role in select CS phenotypes. Combining a "mechanical" afterload reduction with an increase in mean arterial pressure, this device appears particularly suited to treat acute decompensated heart failure-CS and the mechanical complications of an acute myocardial infarction, as these conditions would greatly benefit from systemic afterload reduction. Notwithstanding the negative results of IABP support for acute myocardial infarction-related CS, this document reviews other potential established and emerging settings of application. SUMMARY: In this scoping review, we discuss the IABP design and hemodynamic effects, with a pathophysiology-oriented outlook to its clinical use. Different options for IABP device insertion, potential complications, and optimal device synchronization with cardiac cycle are also summarized with the aim to provide an updated, pragmatic guide to critical care physicians using these devices.
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Baldetti et al. (2025) conducted a review in Cardiogenic shock. Intra-aortic balloon pump (IABP) was evaluated. The intra-aortic balloon pump remains a widely used mechanical circulatory support device, particularly suited for acute decompensated heart failure-cardiogenic shock and mechanical complications of AMI.
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