When is the IABP timed to deflate?
In normal inflation-deflation timing, balloon inflation occurs at the onset of diastole, after aortic valve closure; deflation occurs during isovolumetric contraction, just before the aortic valve opens. In a properly timed waveform, as shown, the inflation point lies at or slightly above the dicrotic notch.
When is the IABP inflate?
IABP inflates at the onset of diastole, thereby increasing diastolic pressure and deflates just before systole, thus reducing LV afterload.
How do I verify my IABP placement?
In the intensive care unit, chest radiographs are the standard way to confirm IABP placement. The IABP tip just distal to the aortic knob is often used as the radiographic landmark, although data suggest that 2 cm above the carina may be a more reliable guide.
What should augmentation be on balloon pump?
Treatment with the intraaortic balloon pump (IABP) is the most common form of mechanical support for the failing heart. Augmentation of diastolic pressure during balloon inflation contributes to the coronary circulation and the presystolic deflation of the balloon reduces the resistance to systolic output.
How long can IABP be used?
The catheter connects to a computer that controls the rate of inflation and deflation. While most patients only use the IABP for a few days, it can stay in place for up to a month.
How do you advance an IABP?
Advance IAB catheter through sheath using short strokes until correct placement is achieved, then advance sheath seal into hub of sheath. Remove IAB catheter from T-handle by pulling STRAIGHT out to avoid damaging it. Do not dip, wipe, or handle membrane prior to insertion.
Where does the balloon pump sit?
The IABP is placed inside your aorta, the artery that takes blood from the heart to the rest of the body. The balloon on the end of the catheter inflates and deflates with the rhythm of your heart. This helps your heart pump blood to the body.
Does IABP increase cardiac output?
The IABP increases diastolic blood pressure, decreases afterload, decreases myocardial oxygen consumption, increases coronary artery perfusion, and modestly enhances cardiac output. The IABP also provides modest ventricular unloading while also increasing mean arterial pressure and coronary blood flow.
Which condition is a contraindication for IABP use?
Absolute contraindications for IABP counterpulsation are a dissecting aortic aneurysm, severe aortic regurgitation, a large arteriovenous shunt, and severe coagulopathy.
What can the IABP waveform be used for?
The pressure waveform generated by the IABP can be used to assess the effectiveness of counterpulsation, and to troubleshoot the balloon pump setup. Poorly synchronised balloon inflation and deflation timing can be massively detrimental (or at least unproductive).
When does the normal IABP balloon inflate?
The normal IABP balloon waveform The balloon itself has a pressure transducer, and it generates a waveform. About 40 milliseconds before the dicrotic notch, the IABP balloon inflates. This is timed with the ECG, usually – the end of the T wave is used as a marker that systole has finished.
How to interpret intra-aortic balloon pump waveforms?
Interpreting intra-aortic balloon pump waveforms 1 Early inflation. The inflation point lies before the dicrotic notch, during systole, before the aortic valve is closed, which dangerously increases myocardial stress and decreases CO. 2 Early deflation. 3 Late inflation. 4 Late deflation.
How does the IABP pump counter pulsation work?
IABP works using the principle of counter-pulsation. This refers to the alternating of inflation and deflation of the balloon, during diastole and systole. The mechanical pump uses the R wave on the ECG or the arterial systolic pressure to identify the cardiac cycle.