TY - JOUR
T1 - Modeling the Interaction Between the Intra-Aortic Balloon Pump and the Cardiovascular System: The Effect of Timing
AU - Schampaert, Stephanie
AU - Rutten, Marcel C. M.
AU - van 't Veer, Marcel
AU - van Nunen, Lokien X.
AU - Tonino, Pim A. L.
AU - Pijls, Nico H. J.
AU - van de Vosse, Frans N.
PY - 2013
Y1 - 2013
N2 - Because of the large number of interaction factors involved, the effects of the intra-aortic balloon pump (IABP) have not been investigated deeply. To enhance its clinical efficiency and to better define indications for use, advanced models are required to test the interaction between the IABP and the cardiovascular system. A patient with mild blood pressure depression and a lowered cardiac output is modeled in a lumped parameter computational model, developed with physiologically representative elements for relevant components of circulation and device. IABP support is applied, and the moments of balloon inflation and deflation are varied around their conventional timing modes. For validation purposes, timing is adapted within acceptable ranges in ten patients undergoing IABP therapy for typical clinical indications. In both model and patients, the IABP induces a diastolic blood pressure augmentation as well as a systolic reduction in afterload. The support capabilities of the IABP benefit the most when the balloon is deflated simultaneously with ventricular contraction, whereas inflation before onset of diastole unconditionally interferes with ejection. The physiologic response makes the model an excellent tool for testing the interaction between the IABP and the cardiovascular system, and how alterations of specific IABP parameters (i.e., timing) affect this coupling.
AB - Because of the large number of interaction factors involved, the effects of the intra-aortic balloon pump (IABP) have not been investigated deeply. To enhance its clinical efficiency and to better define indications for use, advanced models are required to test the interaction between the IABP and the cardiovascular system. A patient with mild blood pressure depression and a lowered cardiac output is modeled in a lumped parameter computational model, developed with physiologically representative elements for relevant components of circulation and device. IABP support is applied, and the moments of balloon inflation and deflation are varied around their conventional timing modes. For validation purposes, timing is adapted within acceptable ranges in ten patients undergoing IABP therapy for typical clinical indications. In both model and patients, the IABP induces a diastolic blood pressure augmentation as well as a systolic reduction in afterload. The support capabilities of the IABP benefit the most when the balloon is deflated simultaneously with ventricular contraction, whereas inflation before onset of diastole unconditionally interferes with ejection. The physiologic response makes the model an excellent tool for testing the interaction between the IABP and the cardiovascular system, and how alterations of specific IABP parameters (i.e., timing) affect this coupling.
KW - intra-aortic balloon pump (IABP)
KW - cardiovascular system
KW - lumped parameter model
KW - timing
U2 - 10.1097/MAT.0b013e3182768ba9
DO - 10.1097/MAT.0b013e3182768ba9
M3 - Article
SN - 1058-2916
VL - 59
SP - 30
EP - 36
JO - Asaio Journal
JF - Asaio Journal
IS - 1
ER -