IABPs, LVADs, and ECMO Flashcards
The IABP improves the balance between myocardial oxygen _______ and _______
supply and demand
Indications for IABP
-Cardiogenic shock
-Myocardial infarction
-Intractable angina
-Difficult separation from cardiopulmonary bypass
Contraindications for IABP
-Severe aortic insufficiency
-Descending aortic disease
-severe PVD
-Sepsis
IABP balloon is inserted through the ______ ______ and advanced along the ______ _____
-femoral artery
-descending aorta
the tip of the balloon should be positioned ___cm distal to the ______ _______ artery.
-2 cm
-left subclavian artery
IABP: proper position is confirmed with ____, _____, or ____.
CXR, fluoroscopy, or TEE
When does the IABP inflate?
When the aortic valve closes at the beginning of diastole
_______ correlates with the dicrotic notch on the aortic pressure waveform.
Inflation
The balloon deflates just before the onset of ______.
This correlates with the ____ wave on the EKG.
systole
R wave
Balloon ______ causes a vacuum-like effect that reduces _______ and reduces _____ _____ work. This reduces myocardial ______ _____.
deflation
afterload
left ventricular work
oxygen demand
Most common complications of IABP:
vascular injury, infection at site
thrombocytopenia
LVAD pump flow is highly dependent on ….. (3)
-adequate LV preload
-pump speed (RPMs)
-pressure gradient across the pump (afterload)
Most common cause of death with LVAD
Sepsis
Common complication with LVAD:
GI bleeding
Fluid administration would increase ____ and reduce ______ _______
-increase preload
-reduce pump speed