Pulsatile flow induced by the intra-aortic balloon pump during cardipulmonary bypass. Literature review

Abstract

Introduction: Different techniques and devices were developed with the aim of imitating pulsatile flow during cardiopulmonary bypass (CPB), although all without result. The main limiting factors are the complexity of the CPB systems and the trauma to the blood elements imposed by them. Still, the benefits of using counterpulsation have been widely highlighted in different clinical investigations. One of the proposals to obtain pulsatile flow is the use of the intra-aortic counterpulsation balloon (IAPB) during the CPB. However, few centers have the habit of maintaining the BCIA with the aim of generating pulsatile flow during the CPB. Objective: To carry out a critical analysis on the maintenance of activated IAPB during the CPB. For this, a literature review was carried out. Results: The use of pulsatile flow induced by IAPB exerts benefits on tissue perfusion in relation to continuous flow without deleterious effect associated; however, most of the studies presented do not show significant differences in the morbidity and mortality associated with the use of this approach. Conclusion: In this way, it is concluded that, despite controversies regarding the advantages of using pulsatile flow produced by the IAPB during the CPB, this practice is fertile ground for future research, taking into account the possibilities to obtain a flow pattern similar to the physiological during CPB.