Background: The use of intra-aortic balloon pump (IABP) has saved the lives of so many critically-ill cardiac patients. However, despite its benefits, complications arise from IABP implantation including vascular problems like dissection, perforation, ischemic extremity, thrombocytopenia, and even death. Despite its long history of clinical use, no thorough review of clinical outcomes associated with its use has been published. This study aims to determine the factors associated with the vascular complications in patients with IABP.
Methods: This is a retrospective cohort done among adult patients who underwent IABP insertion at Philippine Heart Center from January 2008 to December 2013. Sample size was computed and samples were randomly selected from a list of patients who underwent IABP insertion during the specified period. Chart review was done and variables were recorded in a constructed data gathering tool. The following variables were noted in this study: age, sex, BMI, duration, indications, and timing of IABP, procedure/s associated with the insertion, presence of co-morbidities, and presence of vascular complications.
Results: There were 132 eligible patients that were enrolled in this study. The mean age of the sample population is 62 ± 9.51 years. There were 93 males (70.45%) and 39 females (29.55%) in the study. Among the recruited subjects, 92 patients developed vascular complications (69.70%) while 40 patients (30.30%) were spared. The mean age of those who developed vascular complications was 62 ± 8.88 years while those who did not develop vascular complications was 60 ± 10.89 years. The average number of days on IABP in patients with vascular complications was 3.94 ± 3.12 days with 1.39 times more likely to develop vascular complications and was statistically significant with a p-value of 0.007.For those patients whose IABP was inserted during coronary angiography and/or percutaneous coronary intervention (PCI), they were 2.5 times more likely to develop vascular complications and was clinically significant with a p-value of 0.024. Patients who are diabetics on insulin, with MI, valvular heart disease, stroke, smoker, pulmonary disease, critical CAD, refractory chest pain, and increased left ventricular end diastolic pressure (LVEDP) are at increased likelihood to develop vascular complications but p values did not reach statistical significance.
Conclusion: A mean IABP duration of 4 days and coronary angiography and/or PCI are significantly associated with vascular complications among patients who underwent IABP insertion.