Key result
Operating an IABP at a 10° angle in a mock circulation decreased augmentation pressure by 10%, relative mean pressure by 25%, and compression energy by 13% compared to a horizontal position.
Why the study?
Does operating an IABP at a 10° angle compared to a horizontal position alter hemodynamic parameters in a mock circulation model?
Does operating an IABP at a 10° angle compared to a horizontal position alter hemodynamic parameters in a mock circulation model?
Operating an IABP at an angle mimicking a patient's posture in bed reduces its hemodynamic benefits compared to a horizontal position in a mock circulation model.
Answers are grounded in this paper and cite their sources.
IABP angle may reduce hemodynamic support in mock models; leaves open whether patient positioning affects clinical efficacy.
Purpose: The effects of operating the IABP on the energies generated by the inflation and deflation of the balloon have been investigated. We aimed to study the results of the IABP when operated at different angles to the horizontal, mimicking patient’s posture in bed. Methods: An IABP (Datascope) was placed in a true size latex aorta, operated at the horizontal and at an angle of 10°, which was achieved by tilting the artificial aorta (distal end was lowered). The ascending aorta was attached to a LVAD operated by a counter-pulsation pump. Pressure and flow were measured at the ascending aorta for 5 consecutive beats. The energy generated by the inflation of the balloon was calculated using wave intensity analysis. Results: When the balloon was placed at 10° the augmentation pressure due to inflation decreased by 10% and relative mean pressure also decreased by 25%. The backward flow and the compression energy generated by the balloon inflation were decreased by 25% and 13% consecutively. The peak expansion wave was always greater than the peak of the compression wave, but the peak expansion energy due to balloon deflation increased by approximately 10%. Conclusions: Using wave intensity analysis allows for calculating the energies generated by the inflation and deflation of the balloon. Operating the balloon at an angle to the horizontal in a mock circulation resulted in a reduced benefit than that achieved when the balloon operated at the horizontal position.
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Swalen et al. (2005) studied this question. IABP operated at an angle of 10° vs. IABP operated at the horizontal was evaluated on Energies generated by the inflation and deflation of the balloon. Operating an IABP at a 10° angle in a mock circulation decreased augmentation pressure by 10%, relative mean pressure by 25%, and compression energy by 13% compared to a horizontal position.
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