Chapter 25:Intraaortic Balloon Pump and VADs

Question 1

What is the primary purpose of IABP?

Answer 1

It is used in patients with heart failure to decrease afterload and assist with diastole to improve coronary perfusion.

Question 2

What is the volume of the intraaortic balloon?

Answer 2

30-50ml

Question 3

What gas is usually used to inflate the balloon?

Answer 3

Helium

Question 4

The frequency at which the balloon is inflated can be adjusted to what settings?

Answer 4

1: 1
1: 2 (every other cardiac cycle–most common)
1: 3 (every third cardiac cycle)

Question 5

Systemic increase in BP ensures the efficacy of the IABP. True of false?

Answer 5

False, it is a misconception that increase in BP indicates that the IABP is functioning properly.

Question 6

In what situations is IABP ideal?

Answer 6

Temporary myocardial dysfunction such as postcardiotomy cardiogenic shock, weaning from CPB, post-infarction angina

Question 7

When is IABP absolutely contraindicated?

Answer 7

Aortic insufficiency or dissection

Question 8

What are relative contraindications to IABP?

Answer 8

Vascular consequences to cannulation such as aortic aneurysms, iliofemoral disease, etc.

Question 9

When are VADs (ventricular assist device) considered?

Answer 9

Pts with the following:
Cardiac index < 2 L/min/m2
Systolic < 90
Increased R atrial pressures
Increased SVR

Question 10

Indications for VAD:

Answer 10

Postcardiotomy shock 
Cardiogenic shock
Decompensated heart failure
Acute myocarditis
Ventricular arrhythmias

Question 11

Contraindications for VAD:

Answer 11

Irreversible end-organ failure

IRREVERSIBLE NEUROLOGICAL INJURY

Question 12

What pump is newer, has less contact surface, and are good for smaller patients?

Answer 12

Axial flow pump