IABP Therapy Flashcards
IABP Therapy Goals
Theory of counter-pulsation
Decrease afterload
Increase diastole pressure. (displaces blood into the coronary arteries)
Inflate on diastole
Deflate on systole
Indication for IABP Therapy
Cardiogenic Shock (most commonly seen on exam)
Cardiac failure after related surgical procedure
Mitral regurgitation
Complications due to OMI
Failed PTCA (angiography)
Contraindications for balloon pump therapy
Severe Aortic Insufficiency (SEVERE)
Aortic Aneurysm
Aortic Dissection
Limb Ischemia - Severe vascular insufficiency.
Thromboembolism - Can potentiate and form clots.
Gas for IABP Therapy
Helium
Small molecule - Allows for rapid gas transport
In case of balloon rupture, gas will diffuse into bloodstream without complications. (inert)
Complications
Tip is 1-2 cm below the origin of the left subclavian artery and above renal arteries.
Monitor affected limb.
Monitor renal output.
Triggering Signals
ECG
Arterial Waveform
Pacer
IABP Cardiac Arrest
Change to arterial pressure trigger and start CPR. After ROSC, you can return to ECG trigger.
Frequency
For transport always keep on 1:1.
Place IABP on 1:2 for assessment or tachycardia (>130 HR continuously)
Early Inflation
Balloon Inflation before closure of Aortic Valve. This will potentially send blood back through the valve into the left ventricle.
Increases pressures and causes regurgitation and premature opening of aortic valve. Increases afterload and can lead to pulmonary edema.
Diacrotic Notch will be hidden.
Late inflation
“w”
Diacrotic notch is exposed.
Early Deflation
Dramatic ski slope
Suboptimal afterload reduction
Late Deflation
MOST HARMFUL.
Stays inflated during systole.
Plateau appearance with a drop to a small V
Increased assisted pressures
Troubleshooting
Checks leads
Switch lead source
Switch trigger source to A wave
