• A T Cheung, W J Levy, S J Weiss, D K Barclay, and M M Stecker.
• Department of Anesthesia, University of Pennsylvania, Philadelphia 19104-4283, USA.
• J. Cardiothorac. Vasc. Anesth. 1998 Feb 1; 12 (1): 51-7.

ObjectiveTo determine the effects of intra-aortic counterpulsation (IABP) on cerebral blood flow velocity.DesignProspective self-controlled study.SettingUniversity hospital surgical intensive care unit.ParticipantsNineteen cardiac surgical patients requiring perioperative IABP assistance.InterventionsSimultaneous recording of transcranial Doppler middle cerebral artery blood flow velocity and arterial pressure in response to changes in the magnitude of augmentation and trigger ratio.Measurements And Main ResultsInstantaneous cerebral blood flow velocities correlated with arterial pressures during IABP (r = 0.650) at different magnitudes of augmentation and trigger ratios. The increase in arterial pressure during balloon inflation was associated with an increase in cerebral blood flow velocity, and the decrease in arterial pressure in response to balloon deflation was associated with a decrease in cerebral blood flow velocity that was dependent on the magnitude of augmentation. Different magnitudes of augmentation or trigger ratios had no effect on peak systolic cerebral blood flow velocity, mean cerebral blood flow velocity, mean arterial pressure, or the mean velocity-to-pressure ratio. Instantaneous cerebral blood flow velocity to arterial pressure ratios were lowest in response to balloon deflation at the time of pre-ejection.ConclusionsIABP modified the phasic profile of cerebral blood flow to reflect the arterial pressure waveform without affecting mean cerebral blood flow velocity. Peak systolic cerebral blood flow velocity was maintained in augmented beats despite the decreased systolic arterial pressure associated with afterload reduction. The acute decrease in cerebral blood flow velocity at pre-ejection was balanced by increased cerebral blood flow velocity during balloon inflation in diastole.

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