NO, Balloon Pumps, and Mechanical Ventilation

Question 1

The following waveform shows what abnormality? what problems are associated with it?

Answer 1

premature deflation of IAB - decreased effectiveness, suction effect can cause angina

Question 2

The following waveform shows what abnormality? what problems are associated with it?

Answer 2

premature inflation of IAB - (blood is pushed back while atrial valve still open) can cause regurg and increase LV wall stress

Question 3

The following waveform shows what abnormality? what problems are associated with it?

Answer 3

correct IAB inflation time

Question 4

The following waveform shows what abnormality? what problems are associated with it?

Answer 4

late IAB inflation - marked decrease in effectiveness

Question 5

The following waveform shows what abnormality? what problems are associated with it?

Answer 5

late deflation - high end diastolic P, no decrease in afterload, higher LV O2 demand

Question 6

What is the following abnormality? how can you tell?

Answer 6

early deflation; unassisted and assisted systolic P are the same (assisted systolic P [right after deflation] should be lower because of “suckdown effect”)

Question 7

What is the following abnormality? how can you tell?

Answer 7

impossible to tell because all waves are assisted (nothing to compare against)

Question 8

What is the following abnormality? how can you tell?

Answer 8

late deflation; LVEDP is lower for unassisted than assisted

Question 9

In IABP, if assisted and unassisted systolic pressure, then the balloon is ____ too _____.

Answer 9

deflation, early (assisted systolic P should be higher than unassisted systolic P - remember that assisted systolic P is the one that comes directly after balloon deflation)

Question 10

In IABP, if unassisted end diastolic P is lower than assisted diastolic P, then balloon is ____ too ____.

Answer 10

deflating, late (assisted end diastolic pressure should be lower)

Question 11

Which of the following is not a target variable?

• time
• pressure
• volume
• flow

Answer 11

time; a target variable is something that is reached then held during inspriation (think of the rectangular pressure curve)

Question 12

Can a spontaneous breath be assisted, unassisted or both?

Answer 12

both

Question 13

Can an assisted breath be assisted, unassisted, or both?

Answer 13

assissted

Question 14

Can a mandatory breath be unassissted?

Answer 14

no

Question 15

Can a patient trigger a mandatory breath?

Answer 15

yes, if the ventilator ends the breath

Question 16

In general, what should the FiO2 be set to?

Answer 16

the lowest possible to maintain 100% O2sat