European Journal of Anaesthesiology. 22(3):165–170, MARCH 2005

DOI: 10.1017/S0265021505000293

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PMID: 15852987

Issn Print: 0265-0215

Publication Date: March 2005


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Influence of intra-aortic balloon pumping on cerebral blood flow pattern in patients after cardiac surgery

A. Schachtrupp;H. Wrigge;T. Busch;W. Buhre;A. Weyland;

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Abstract

SummaryBackground and objective:The effects of intra-aortic balloon pumping (IABP) on cerebral perfusion are still a matter of debate. End-diastolic reversal of blood flow in cerebral arteries has been observed in a small number of patients. We prospectively investigated the incidence and the amount of transient cerebral artery blood flow reversal during balloon pumping in patients recovering from cardiac surgery.Methods:In 23 patients receiving IABP support, blood flow velocities in the right middle cerebral artery were assessed by transcranial Doppler-sonography. Additionally, systemic haemodynamics were monitored. In each patient, measurements were performed at three different pump settings: without support, assist ratio 1 : 1 and assist ratio 1 : 2.Results:In 8 of 23 patients, balloon pumping caused a transient diastolic reversal of blood flow in the middle cerebral artery during balloon deflation. Antegrade mean flow velocity in the middle cerebral artery significantly increased from 57 ± 27 to 61 ± 26 (assist ratio 1 : 1) and 61 ± 29 cm s−1 (assist ratio 1 : 2) (P < 0.05). Taking transient blood flow reversal into account, net mean flow velocity did not increase with balloon pump support. Systemic haemodynamic parameters remained unchanged.Conclusion:Left ventricular support with IABP significantly changed flow patterns in basal cerebral arteries of our patients. In 35% of patients, support resulted in a transient reversal of intracranial blood flow which counterbalanced a slight increase in mean antegrade flow.

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