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Effects of intraaortic balloon counterpulsation on middle cerebral artery blood flow velocities


The intraaortic balloon pump has been shown to improve cardiac output and diastolic coronary flow. The aim of our study was to determine the effects of intraaortic counterpulsation (IABP) on cerebral blood flow velocities measured on the middle cerebral artery.


In 11 cardiac surgery patients receiving IABP postoperatively, blood flow velocities in the middle cerebral artery were assessed by transcranial Doppler (TCD). In each patient, measurements of Vmax, Vmean and Vmin were performed at four different pump settings: without support (WS), and at pump assist pulse with ratio 1:1, 1:2 and 1:3.


Repeated-measures analysis of variance: P = 0.0006, considered extremely significant variation of TCD measurements among IABP settings. Comparing all pairs of Vmax, Vmean and Vmin values, we found that Vmax and especially Vmean are significantly greater at the 1:2 and 1:3 pump settings, but not at the 1:1 setting. We also found that the end diastolic velocities (Vmin) were significant lower during the pump deflation. None of our patients had a significant diastolic flow velocity reversal during the pump deflation.


Left ventricular support with IABP significantly changed the flow velocity pattern of our patients. The pump significantly increased the Vmax and the Vmean at the 1:2 and 1:3 settings because of pump inflation during the diastole. We suggest that the velocities did not change at the 1:1 setting because the end-diastolic flow velocities reduce during every pulse, according to pump deflation.

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Vakalos, A., Setzis, D., Doukelis, P. et al. Effects of intraaortic balloon counterpulsation on middle cerebral artery blood flow velocities. Crit Care 11 (Suppl 2), P341 (2007).

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