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Updated: Feb 19, 2026
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Differential responses to larger volume intra-aortic balloon counterpulsation: Hemodynamic and clinical outcomes
David A Baran1, Gautam K Visveswaran2, Ahmed Seliem2
1Division of Advanced Heart Failure, Sentara Heart Hospital, Norfolk, Virginia.
Insights
Intra-aortic balloon pump catheter (IABC) use improves cardiac output in most patients but does not affect in-hospital survival. Further research into cardiogenic shock pathophysiology is needed.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Medical Devices
Background:
- The clinical benefit of intra-aortic balloon pump catheter (IABC) use, despite its 50-year history, remains debated.
- A retrospective review of 76 patients with right heart catheterization data was conducted to assess IABC response and outcomes.
Purpose of the Study:
- To examine the hemodynamic and clinical correlates of intra-aortic balloon pump catheter (IABC) use.
- To assess patient response and outcomes following IABC insertion.
Main Methods:
- Retrospective chart review of 76 patients who received IABC with a 50cc balloon for at least 1 hour.
- Recorded demographics, comorbidities, lab values, and hemodynamic parameters at baseline and 15 hours post-insertion.
Main Results:
- 60 out of 76 patients demonstrated improved cardiac output with IABC (responders).
- Responders showed significant increases in cardiac output (3.6 to 5.2 L/min) and cardiac index (1.8 to 2.6 L/min/m²).
- A baseline cardiac power index of 0.3 or less best predicted IABC response; in-hospital survival was similar between responders and non-responders.
Conclusions:
- Most patients experience improved cardiac output with IABC, but survival rates remain unchanged.
- Further investigation into the pathophysiology of cardiogenic shock is warranted.
Objectives:
Examine hemodynamic and clinical correlates of use of an intra-aortic balloon pump catheter in a single center.
Background:
The intra-aortic balloon pump catheter (IABC) has been used for 50 years but the clinical benefit is still debated. We reviewed 76 patients with right heart catheter measurements prior to IABC to assess response and outcomes.
Methods:
All patients who received IABC with a 50cc balloon for at least 1 hour were included in this retrospective chart review study. Demographics, comorbidities, lab values, and hemodynamic parameters were recorded at baseline and 15 h postinsertion.
Results:
Seventy-six patients had paired measurements of cardiac output. 60 patients had a higher cardiac output with IABC treatment (responder group) and 16 did not (nonresponders). In the 60 patients in the responder group, cardiac output and index significantly increased from baseline 3.6 ± 1.3 L/min to 5.2 ± 1.8 L/min, and 1.8 ± 0.5 L/min/m2 to 2.6 ± 0.8 L/min/m2 respectively following IABC placement (P < 0.0001 for both comparisons). Various hemodynamic variables were examined and the best predictor of response to IABC was a cardiac power index of 0.3 or less. Regardless of response, in hospital survival was similar between groups.
Conclusions:
The majority of patients improve their cardiac output with IABC but survival was unchanged. Further work into the pathophysiology of cardiogenic shock is needed.
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