Echographic assessment of visceral perfusion under intra-aortic balloon pump support.

BACKGROUND

Intra-aortic balloon pump (IABP) is a classical mechanical hemodynamic support device. However, the influence of IABP counterpulsation on visceral flow is still undetermined.

METHODS

This prospective study included 33 patients who were treated with the IABP in a single cardiovascular center. Transabdominal echography was used to evaluate blood flow in the visceral branches under IABP support. The aim of this study is to evaluate the influence of the IABP counterpulsation on visceral perfusion and identify the risks of visceral arterial compromise.

RESULTS

Visceral perfusion was significantly increased under IABP support in the abdominal aorta (from 15.4 [12.1-30.4] ml/beat to 28.0 [16.0-48.1] ml/beat, P < 0.001), the celiac artery (from 6.4 [3.6-11.4] ml/beat to 9.5 [3.4-16.6] ml/beat, P < 0.001), the superior mesenteric artery (from 6.6 [4.7-9.1] ml/beat to 9.9 [4.3-12.6] ml/beat, P < 0.001), and the left renal artery (from 2.4 [1.8-5.2] ml/beat to 4.3 [3.2-6.8] ml/beat, P = 0.002). Perfusion flow decreased under IABP support in 8 patients (24.2%) at multiple visceral vessels. Between patients with increased and decreased visceral flow, aortic diameter at the celiac trunk level was significantly smaller (22.5 [20.8-24.0] mm vs. 20.5 [19.6-22.3] mm, P = 0.002).

CONCLUSION

Visceral flow pattern was a biphasic pulse under IABP support, and total visceral flow was significantly increased. However, a narrow abdominal aorta can be a risk for decreased visceral perfusion.