3.8 IABP Flashcards
Indications
- Unstable Angina
- Acute MI / Ischaemia
- Acute mechanical complication MI
MR - VSD
- Ventricular Arrhy
- Cardiogenic shock
- Refractory Vent failure
- Weaning CPB
- Bridge to tplx
- High risk perc
transluminal cor angio - Complicated paediatric congenital abnorm
Contraindications
Abso
Patient refusal
Irreversible endstage cardiac disease
Mod to severe AR
Aortic dissection
Presence of aortic stents
Contraindications
Relative
Severe Neuro defect
Compromising tachyarrhythmias
AAA
Severe PVD
MOA
Grace Sinai Hspital dteroit in 60s
Augment failing hearts
Intrart device in thoracic aorta
usually via femoral artery
distal to L subclavian and proximal to renal arteies
Consists
Catheter w/ balloon & Pressure transducer
Action
During diastole
Balloon inflated w/ helium
Isolating a column blood between AV + Tip of balloon
Subsequent elastic recoil in aortic wall
increase in pressure
transmitted to cor artery origins
increasing diastolic perfusion gradient
Effects
Primary
1. Increased CPP and DO2
- Reduced Myocardial O2 demand
Secondary
- Drop SVR immediate following deflating
= promotes forward flow
= Increase EF
Reduced EDV and wall tension
This can lead to
Increase CO
Drop HR
Reduced Myocardial Lactate
Complications
- Damage to vessels
- Damage to adjacent structures
- Balloon effects
- Other
Damage to vessels:
False Aneurysm Dissection haematoma formation Vessels suppling GIT -subsequent Gut ischaemia
Damage to adjacent structures
Limb Ischaemia
Limb Compartment syndrome
Loss Peripheral Pulses
Cardiac tamponde
Balloon effects
Rupture = Helium embolus
Immobility - balloon lodged
Malposition
- cerebral / renal circulation issues
Other
Local infection bleeding thrombus formation
emboli
