Pocket ICU by Frendl Gyorgy & Urman Richard D

Author:Frendl, Gyorgy & Urman, Richard D. [Frendl, Gyorgy & Urman, Richard D.]
Language: eng
Format: epub
ISBN: 978-1-4511-7846-3
Publisher: Wolters Kluwer Health
Published: 2012-07-15T14:00:00+00:00

Relative Contraindications

• Severe AI: diastolic balloon inflation → ↑ AI → LV distension → ↓ CPP, ↑ myocardial O2 consumption

• Sepsis

• Severe vascular disease (e.g., AAA or TAA, femoral grafts or vascular dz, etc.)

• Severe LV failure

• Irregular, rapid rhythms → makes IABP synchrony more difficult

Figure 3. Aortic Pressure Waveforms of IABP

Equipment/Components

• Placed intra-operatively, in the Cath Lab or at the bedside emergently via the femoral artery

• Other insertion locations: ascending aortic arch, subclavian artery, axillary artery, iliac artery

• Verify placement with TEE, fluoroscopy or CXR

• On CXR, tip should be at the anterior 2nd intercostal space and 1st lumbar vertebra

• Balloon is threaded to the descending aorta, with the tip just distal to the L subclavian artery take-off and proximal to the renal arteries

• Helium (30–50 ml) used as the inflating gas due to low density, rapid diffusion coef

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