Hemodynamic effects of new intra-aortic balloon counterpulsation timing methods in patients: A multicenter evaluation

Kern, Morton J.; Aguirre, Frank V.; Caracciolo, Eugene A.; Bach, Richard G.; Donohue, Thomas J.; Lasorda, David; Ohman, E. Magnus; Schnitzler, Robert N.; King, Donald L.; Ohley, William J.; Grayzel, Joseph

doi:10.1016/s0002-8703(99)70373-x

Cited by 24 publications

(25 citation statements)

References 30 publications

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“…In contrast, real-time timing allows deflation to occur during the preejection phase or during early systolic ejection and may increase stroke volume because of active deflation during systolic ejection. 3,8,15,16 …”

Section: Methods and Principlesmentioning

confidence: 99%

“…Kern et al 16 studied various deflation timing settings, from early to late, and concluded that later deflation timing increased mean arterial pressure significantly and improved the endomyo cardial viability ratio by significantly increasing the diastolic pressure time index and producing a small, but nonsignificant reduction in the systolic tension time index. Hemodynamically later deflation timing produced a greater reduction in the assisted systole than did earlier deflation and a greater increase in augmented pressure and time.…”

Section: Conventional Timingmentioning

confidence: 99%

“…However, if deflation occurs during systolic ejection, stroke volume remains unchanged or increases slightly and LVSW is slightly decreased. 3,4,16 These www.ajcconline.org Figure 2 The combined effect of the intra-aortic balloon pump (IABP) on endomyocardial viability ratio (balance of myocardial oxygen supply and demand). The systolic tension time index (STTI) represents oxygen demand, and the diastolic pressure time index (DPTI) represents oxygen supply.…”

Section: Conventional Timingmentioning

confidence: 99%

“…Intra-aortic balloon counterpulsation improves the ratio of myocardial oxygen supply and demand, reducing the risk of further ischemia or reductions in contractility. 16 Deflation timing errors are of particular concern because the position of deflation affects both the time and the amount of augmentation, as well as the effectiveness of afterload reduction. In determining the proper deflation timing for a patient, the goals of using counterpulsation and the hemodynamic effects of IABC must be carefully considered.…”

Section: Conventional Timingmentioning

confidence: 99%

“…Most systems select R-wave deflation automatically when arrhythmia is detected. One study 16 suggests that deflation timing should be chosen on the basis of the relationship between the electromechanical delay or preejection period and deflation speed. This approach is used in 1 system to determine whether conditions are appropriate for R-wave deflation.…”

Section: Status Of Automated Iabp Timingmentioning

confidence: 99%

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Intra-aortic Balloon Pump Timing: Review of Evidence Supporting Current Practice

Hanlon-Pena

Quaal

2011

American Journal of Critical Care

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Intra-aortic balloon counterpulsation is the most widely used therapy for support of a compromised left ventricle. The principles of counterpulsation were developed in the 1950s, and intra-aortic balloon pumps have been used for more than 40 years. Despite this long-standing clinical use, many of the timing practices have continued almost unchanged from their inception. One of the most important aspects of the pumps is timing, or synchronizing the action of the device with the cardiac cycle. The principles of timing are based on the physiological objectives of counterpulsation; however, research into alternative timing methods has led to conflicting and often confusing information on the appropriate timing method for a specific clinical situation or patient. Although a body of knowledge is available, much of the research is dated and covers only specific timing methods or populations of patients. Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Describe the pathophysiological effects and goals of intra-aortic balloon pump counterpulsation. 2. Identify factors that affect intra-aortic balloon counterpulsation efficacy and appropriate hemodynamic assessment parameters for evaluating efficacy of counterpulsation therapy. 3. Discuss timing methods, potential timing errors, and considerations for timing of intraaortic balloon pump counterpulsation in specific clinical situations.

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Section: Methods and Principlesmentioning

confidence: 99%

Section: Conventional Timingmentioning

confidence: 99%

Section: Conventional Timingmentioning

confidence: 99%

Section: Conventional Timingmentioning

confidence: 99%

Section: Status Of Automated Iabp Timingmentioning

confidence: 99%

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