Intra Aortic Balloon Pump (IABP)

Basics & Nursing Considerations

DR T VAMSHIDHAR
DNB, CARDIOTHORACIC SURGERY
 Circulatory Assist device
Supports Left Ventricle

Indications
Hemodynamic Support
Stable angina
Cardiogenic Shock
Preop in high risk patients
Mechanical complications post MI
Without IABP

With
IABP
 Percutaneous insertion
Femoral artery
Positioned in descending
thoracic aorta
Tip distal to left
subclavian artery
Proximal to renal
arteries
Chest x ray. Tip between
2nd rd intercostal space
 Size of IABP depends on patients height
Inflation and deflation timed to cardiac cycle
Gas used is helium
IABP inflation occurs just after closure of
aortic valve
Without IABP

With
IABP
Diastole Systole
 Increases coronary
perfusion
Increase myocardial oxygen
supply
Decreases myocardial
oxygen demand
Decreases myocardial work
by reducing afterload
Increases blood pressure
 Diastolic pressure Highest pressure
recorded
Balloon assisted systolic pressure lower
than Non assisted systolic pressure
(reduced afterload)
 Trigger
ECG Using R wave on ECG
Pressure arterial pressure form
Pacer V/AV
Pacer A
Internal
 Contraindications
Severe Aortic regurgitation
Abdominal or Aortic Aneurysm
Aorticdissection
Severe Calcific aorto iliac disease
Severe peripheral vascular diseases
 Complication
Limb Ischemia
Bleeding from insertion site
Thrombo embolism
Thrombocytopenia
Balloon rupture
Aortic dissection
Compartment syndrome
Infection
Renal Failure
Cause
Femoral Artery Obstrucction, Thrombus
Coagulopathy, Veessel damage, Patient
movement
If pump stops for long
Mechanical damage to platelets,
Anticoagulation
Membrane Fatigue, Contact with calcific
plaque
Friable aorta, Connective tissue disorders
(Marfans)
Limb Iscchemia
Failure to maintaain site asepsis
Balloon moves distally
 Nursing Assessment
Cardiovascular
Respiratory
Renal
GastroIntestinal
Skin
CNS
Cardiovascular
Pulses, Systolic, Diastolic, MAP
IABP wave form
ECG leads secure/not
ECG rhythm
Therauptic anticoagulation
Radial and pedal pulses hourly
Respiratory
Respiratory rate hourly
Pulse oxymetry hourly
Deep breathing exercise
Supplemental oxygen
Renal
Urine output hourly
Renal function daily (Serum Creatinine)
GIT
Diet and food intake
Nutrition supplements
Bowels Laxatives
Skin
Elevation 30 deg, Straight leg
Pressure points
IABP insertion site
Hematoma/ Bleeding
CNS
Keep noise levels minimum
Uninterrupted sleep
Pain score
 Systole Diastole Systole

Balloon
Balloon deflates Balloon deflates
Inflates

Increases
Coronary
perfusion
Assessment Question 1
Ans : Early Inflation of IABP
 Systole Diastole Systole

deflates Balloon Inflates Balloon deflates

Increases Myocardial workload

Decreases Stroke volume
Decreases Cardiac output
Assessment Question 2
Ans : Early deflation (U shape)
Systole Diastole Systole

Balloon
deflated deflated
Inflated

decreases
Coronary
perfusion
Assesment Question 3
Ans : Late Inflation
 Systole Diastole Systole

Balloon
Balloon deflates Balloon deflatd
Inflated

decreases
Coronary
perfusion
Asessment Question 4
Ans : Late deflation
 Systole Diastole Systole

Balloon deflates Balloon Inflated deflates

Increases afterload,
Increases myocarial O2 consumption
Increases cardiac workload
Thank You