June 1, 2015 — Maquet Getinge Group announced the publication of a manuscript describing the exploration of the hemodynamic effects of the newer, larger-capacity 50 cc intra-aortic balloon pumps (IABPs) versus 40 cc IABPs in real-world clinical practice. The paper, titled "Hemodynamic Effects of Standard Versus Larger-Capacity Intraaortic Balloon Counterpulsation Pumps," appears in the April 2015 volume of The Journal of Invasive Cardiology.
The study, led by Navin K. Kapur, M.D., assistant director of the Interventional Cardiology Center at Tufts Medical Center; investigator at Tufts Molecular Cardiology Research Institute; and assistant professor at Tufts University School of Medicine, was a retrospective examination of demographic, hemodynamic and laboratory data in 26 consecutive subjects treated with a 50 cc IABP. These patients were compared with 26 patients receiving a 40 cc IABP between 2012 and 2013. IABP tracings were analyzed within 24 hours of implantation in all patients. Pulmonary artery catheter data were available before and after IABP implantation in 20 subjects.
The study found that the larger-capacity 50 cc IABPs provides greater diastolic augmentation and systolic unloading compared with the 40 cc IABP. In the analysis, recipients of the 50 cc IABP were observed to achieve a greater reduction in cardiac filling pressures and increased cardiac output compared with the 40 cc group. It was also observed that a greater number of patients achieved a reduction in systolic pressure in the 50 cc IABP group compared with the 40 cc IABP group — the magnitude of systolic unloading correlates directly with the magnitude of diastolic augmentation and inversely with pulmonary artery occlusion pressure. Taken together, these observations suggest that the 50 cc IABP may achieve a greater hemodynamic effect compared with the standard 40 cc IABP.
"The intra-aortic balloon pump remains the most widely used form of mechanical hemodynamic support for cardiac patients because of their clinical efficacy and safety profile across a broad range of patient care scenarios," said Marc Cohen, chief of the Division of Cardiology at Newark Beth Israel Medical Center, Newark, New Jersey, and professor of medicine at Rutgers-New Jersey Medical School. "Given IABPs' continuing role in the management of high-risk patients with and without cardiogenic shock, new research into the newer 50 cc balloon is key to better understanding the role of IABPs in the modern era of acute cardiovascular care. The 50 cc IABP recipients demonstrated higher augmented diastolic blood pressure and greater systolic unloading compared to 40 cc IAB patients which is encouraging and warrants more research into whether this larger capacity balloon offers meaningful morbidity and mortality benefits."
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