Cardiology in Critical Care
Intra-aortic Balloon Pump
IABP
nursebob
Principles of
Intraaortic Balloon Pump Therapy.
The purpose of IABP is to increases the oxygen supply
to allow the heart muscle to rest and improves perfusion to the coronary
arteries. The Intraaortic balloon is placed within the descending aorta. As the IABP inflates and deflates it allows
an increase in oxygen supply to the myocardium, decreases workload of the left
ventricle and increases cardiac output and perfusion of the vital organs. The device is designed to inflate and deflate
with each heart beat.
The balloon
will inflate during diastole causing blood to be forced back
toward the extremities as well as into the coronary arteries and main branches
of the aortic arch. Before systole the balloon will
deflate resulting in decreased pressure within the aorta. This action result in
less work for the left ventricle, to expel blood during contraction and
Counterindications of Intraaortic Balloon Pump Therapy
There are certain conditions when the IABP should not be
used; aortic valve regurgitation, aortic aneurysm, severe peripheral
vascular disease, coagulopathy, or end-stage heart
disease not awaiting transplant.
Placement of the Intraaortic Balloon
The position of the intra-aortic balloon is critical to its effectiveness.
It must be positioned in the descending thoracic aorta
slightly distal to the subclavian artery. This position must
be verified by chest xray. The
tip of the balloon should be just below the level of the aortic knob, and
should be in a straight line curving to the right. This would indicate the tip
of the balloon has entered the aortic arch.
Balloon sizes may varry but the Red 9.5 fr. and the Yellow 8.5 are the most common sizes used. Proper positioning is important to insure
effectiveness in coronary and renal artery perfusion. Proper placement must be
verified by initial and daily chest xray
Intraaortic Balloon Pump Timing
The balloon should inflate during the diastolic phase of the cardiac cycle. Counterpulsation should be achieved
during deflation of the intraaortic balloon during
the systolic phase of the cardiac cycle. The intraaortic
balloon, identifies the R wave as a triggering event
in most cases. Once the R wave has been identified the
balloon pump inflates. Deflation will continue throughout the systolic phase of
the cardiac cycle. During the diastolic phase of the cardiac cycle inflation
occurs. By setting the inflation marker at the diacromatic
notch, inflation will continue until the next R wave of the next QRS occurs.
Nursing Care of the Patient Undergoing Intraaortic Balloon Pump Therapy
1. Only nurses who have
been trained in the timing and trouble shooting of the Intraaortic
balloon pump should be caring for IABP patients. The Nurse/Patient ratio for a
patient with an IABP is 1:1.
Rationale: This
is to provide safe, consistent levels of nursing care for IABP patients. The nurse assigned to relieve for breaks will
be approved to care for the patient on the IABP.
2. Ensure that a set
of skin and external leads are connected and functional. Select the desired ECG source from waveform selector in the IABP
controls.
Rationale: A back-up triggering mode must be readily available. Adjust trigger
modes as required to ensure balloon pumping.
3. The ECG trigger will be used for most situations. Pressure
trigger is a sutable trigger if the ECG is
temporarily lost or if the patient has no ECG rhythm and is receiving CPR. The pacemaker trigger should
be avoided. After changing the
trigger mode the assist button must be pressed to
resume pumping.
Rationale: Trigger modes may require changing to ensure optimal balloon function. When using the pressure trigger during CPR or
severe hypotension, the pressure threshold can
be reduced to ensure that the pump recognizes systolic events. Adjust by
using the arrows in the auxiliary trigger option. ECG trigger mode will work well for patients being paced. The pacemaker trigger modes will only
work for fixed rate pacing. If the patient is in a pacemaker trigger
mode, the pump will ignore native beats and only operate with paced impulses.
4. A previously prepared and zeroed transducer
is connected to the aortic arterial line of the balloon and then to the
IABP. This should be
secured level with the patient’s mid-axillary
line. This position should
be rechecked hourly and with each patient repositioning.
Rationale: The pressure module provides an alternate
blood pressure source in the event that the bedside monitor should fail. The IABP pressure should be the one that is
treated.
5. The pressures
are to be recorded on the flow sheet every hour. These include Ba. Assisted
Peak Pressure. (APSP), Ba. Assisted Aortic End Diastolic Pressure
(BaEDP), Diastolic Augmentation (DA), and Unassisted Aortic End diastolic
pressure (EDP). The pressures from the IABP are the ones that should be treated. Unless it can be
determined that the IABP is giving an inaccurate reading. Vasoactive drugs should be titrated according
to the mean blood pressure (MAP) from the IABP console. The BP from the IABP console should be used when calculating hemodynamics.
Rationale: When the IABP is timed adequately the
diastolic blood pressure (DBP) is augmented to be
higher than the systolic blood pressure (SBP). The SBP will be the
highest pressured on the bedside monitor.
If the balloon is successful at augmenting the DBP
above the SBP, the SBP
displayed by the bedside monitor will actually be the augmented DBP.
If
augmentation is sub optimal, the augmented pressure may not exceed the SBP...in this case, the SBP will remain the highest pressure and will be displayed
by the bedside monitor appropriately. The IABP console differentiates between the SBP, augmented pressure and end diastolic
pressure. It will also display assisted and unassisted systole and
diastole if the pump is placed in 1:2 or 1:3.
Aortic and peripheral systolic and diastolic
pressures are not necessarily the same; peripheral arterial lines often amplify
the SBP. Mean BP will usually correlate much
more closely and is a better indicator of BP. Aortic pressure represents the central or core BP. It is a better
indicator of BP than a peripheral arterial line, as long as the aortic line is
patent and displaying accurate values. Pressure trends and consistency among pressure measurements are the most
important findings.
6. Evaluate Cardiac Output within 1 hour of any
change in the assist interval.
Rationale: To assess whether
the change is tolerated.
7. Obtain an arterial timing strip and balloon
waveform q.12.h. And PRN. Evaluate the timing and attach
the tracing to the IABP record.
Rationale: To evaluate timing and provide a record for
future reference.
8. If the augmentation volume is reduced for the purpose of weaning, return the pump to full
augmentation volume at a ratio of 1:1 for 5 minutes each hour.
Do not
increase the augmentation volume if the balloon volume has
been reduced due to aortic size.
Rationale: To reduce risk of
platelet aggregation. Balloons
that do not fully inflate are prone to vertical folds which
can predispose the balloon to rupture.
Ideally,
appropriately size balloons are inserted that permit full inflation.
Occasionally, patients can be temporarily vasoconstricted,
necessitating balloon volume reduction. Balloon volume increases may be
possible as the patient's condition improves.
9. Assess capillary
refill and pedal pulses q1h. Assess
capillary refill and left radial pulse at the start of each shift and
q1h. Notify the
physician of any change from the previous hour. Document on
flow sheet and nursing note.
Rationale: The balloon catheter or thrombus can obstruct
flow to the distal extremities. If the balloon migrates too high, it can obstruct
flow to the left subclavian artery.
10. Change site site
dressing per CVL dressing procedure and policy for your instution.
Observe
site and report any signs of infection to the physician.
Rationale: To minimize risk of infection.
11. The patient will have a daily chest x- ray.
Rationale: To assess position of the IAB
and to assess for sign of pulmonary complications
12. Maintain HOB 300. Avoid hip flexion. Log roll or straight lift
for CXR.
Rationale: Hip flexion can put strain on the insertion
site and cause vascular trauma. Raising the head of the bed can shorten the
aorta and permit migration of the IABP catheter. Ideally, keep the HOB elevated versus supine, to
reduce risk for aspiration.
13. Provide chest vibration to promote secretion
clearance q4h - 6h and prn
Rationale: Immobility and sternal pain predispose
patient to secretions and atelectasis.
14. Measure urinary output q1h.
Rationale: Decreased urine production can occur as a result of low cardiac output, balloon placement that is
too low, prerenal failure from a thrombus, or
hypotensive shock.
15. Perform a neurologic
assessment, using the Glasgow Coma, q1h if unconscious or q. shift if the
patient is awake.
Rationale: Decrease C.O.,
cerebral embolus or migration of IAB may
impair cerebral function. ICU psychosis secondary to sensory overload/sensory deprivation/sleep
deprivation is common.
16. Change the assist
interval as required to assess the adequacy of balloon
timing. Obtain an order to change the
assist interval for reasons other than timing assessment. Return the patient to the
previously tolerated assist control interval if signs of intolerance are
observed during weaning (e.g. chest pain, hypotension, arrhythmias, ST changes).
Notify
the physician if signs of intolerance are identified.
Rationale: The assist interval must be in 1:2 or 1:3 to evaluate deflation. If the patient demonstrates evidence of myocardial ischemia/dysfunction related to weaning, prompt correction must take place to prevent permanent myocardial injury.
17. Take corrective action when the "helium
low" light illuminates.
Note
that 24 fills remain from the time when the low helium light illuminates.
Rationale: The pump automatically refills 2 hours from the last fill. If no additional
fills are initiated, the pump should continue to
operate for 48 hours following a low helium alert. A IABP approved
nurse may change the helium tank or switch to a new pump, if required
18. In the event of sudden pump failure at night, it may be much quicker to have security assess a new pump. The System 98, made by Datascope, is very easy to initiate:
To switch pumps, transfer the helium line, pressure transducer and ECG leads from the back of the malfunctioning pump to the new pump.
Ensure that the helium tank is open (counter-clockwise) and position the inflation and deflation markers midposition. initiated.
For on-line help, select the
"HELP" key.
Turn the pump on. Wait until
the ready signal appears. Pumping can now be resumed.
Obtain another pump immediately in
the event of pump shutdown due to a console failure.
Initiate manual inflation and
deflation of the balloon if 15-20 minutes of balloon inactivity occurs.
Inflate and deflate 8-10 time per
minute with air, using a volume 10 cc less than the balloon size (the balloon
size is marked on the balloon catheter). A slip lock syringe is required
to fit the helium line.
Air is instilled
into the lumen where helium is normally inserted. Never instill air into the
aortic or arterial lumen of the catheter.
Never manually inflate a balloon if
rupture is suspected.
Notify the
cardiologist/cardiovascular surgeon immediately in the event of a static
balloon. Manual inflation
and deflation is done to prevent clot formation; there
is no attempt to provide cardiac assistance with manual inflation.
The goal is to quickly expand and
collapse the balloon. The volume of air used should be 10 cc less than
the size of the balloon. Rapid deflation is desired to
minimize the risk of impeding ventricular outflow. We are not attempting
to mimic the pump, therefore, the timing of the
balloon movement to the cardiac cycle is not important.
The following must
be done each hour:
1. Every hour, fast flush on stand by to keep clots
from forming at the tip of the IABP catheter.
2. Record IABP pressures hourly, these include Ba. Assisted
Peak Pressure, (APSP), Ba, Assisted Aortic End Diastolic Pressure (BaEDP), Diastolic
Augmentation (DA), and Unassisted Aortic End diastolic pressure (EDP).
3. Use minimal tubing necessary in the transducer to insure accuracy.
4. Listen between second and third
intercostal space for placement, the sound should be in the same location. At times, the IABP can migrate from its
intended location.
5. Check urine output every hour. The balloon can migrate to the renal artery.
6. Check the left radial artery.
7. Take chest Xray flat.
8. MAP most important.
9. Limb ischemia is the most common complication.
10. Keep blood pressure low.
11. If bleeding- press one inch above site. Do not press on site.
References:
1. Christenson, J.T., et al, Optimal timing of
preoperative intraaortic balloon pump support in high
risk coronary patients, Annals of Thoracic Surgery 1999; 68:934-939.
2. Christenson, J.T., et al, Preoperative intraaortic balloon pump therapy in high risk coronary patients
- impact on post operative ionotropic drug use,
Today's Therapeutic Trends 17(3);217-225, 1999.
3. Christenson, J.T., et al, European Journal of
Cardiothoracic Surgery;11 (1997):1097-1103.
4. Christenson, J.T., et al, Annals
of Thoracic Surgery 1997; 64: 1237-1244.
All comments and questions about content at this site should
be sent to Nurse Bob
Return to Nurse Bob's™ Page © 07/25/10There
have been Visitors
to this page.
Cardiology In Critical Care
IABP Intraaortic Balloon
Pump
Reference Chart
|
IABP PRINCIPALS The IABP inflates and deflates in the patients descending aorta allowing
an increase in oxygen supply to the myocardium, decreases workload of the
left ventricle and increases cardiac output and perfusion of the vital
organs. POSITIONING
|
|
COUNTERPULSATION-HOW ITWORKS IABP TIMING Baloon Sizes |
|
Procedure |
Rationale |
|
1 The nurse assigned to
relieve for breaks will be approved to care for the
patient on the IABP. |
1 The nurse responsible
for the IABP must be able to maintain and troubleshoot the pump. |
|
2 |
2 Select the desired ECG
source from the Patient Waveform box on the IABP panel. |
|
3 Use ECG trigger for
most situations. Pressure trigger is
a suitable trigger if the ECG is temporarily lost or the patient has no ECG
rhythm and is receiving CPR. Avoid the use of the
pacemaker trigger modes. Following a change
in trigger mode, the assist button must be re-selected
to resume pumping. |
3 When using the
pressure trigger during CPR or severe hypotension,
the pressure threshold can be reduced to ensure that the pump
recognizes systolic events. Adjust by using the arrows in the auxiliary
trigger option. ECG trigger mode will
work well for patients being paced. The
pacemaker trigger modes will only work for fixed rate pacing. If the
patient is in a pacemaker trigger mode, the pump will ignore native beats and
only operate with paced impulses. |
|
4 Tape
aortic line pressure transducer to the patient level with the mid-axillary line. Check the transducer
position hourly, to ensure that it is level with the mid-axillary
line. |
Monitoring
of the aortic line by the Datascope enables rapid transport of patients while
on the IABP. The Datascope pressure
module provides an alternate BP source in the event that the bedside monitor
should fail. Avoid taping the
transducer to the IABP or mounting on the IV pole, as it is too difficult to accurately level the transducer. |
|
5 Titrate drugs to a desired MEAN BP
obtained from the Datascope monitor. Use the BP obtained from the Datascope
pump when calculating hemodynamics.* |
5 The bedside monitor
displays the SBP as the highest pressure
measured. If the balloon is
successful at augmenting the DBP above the SBP, the SBP displayed by the
bedside monitor will actually be the augmented DBP.
If augmentation is sub
optimal, the augmented pressure may not exceed the SBP...in
this case, the SBP will
remain the highest pressure and will be displayed by the bedside monitor
appropriately. The Datascope console
differentiates between the SBP, augmented pressure
and end diastolic pressure. It will also display assisted and
unassisted systole and diastole if the pump is placed
in 1:2 or 1:3. Aortic and peripheral
systolic and diastolic pressures are not necessarily the same; peripheral
arterial lines often amplify the SBP. Mean BP
will usually correlate much more closely and is a better indicator of BP.
Aortic pressure
represents the central or core BP. It is a better indicator of BP than
a peripheral arterial line, as long as the aortic line is patent and
displaying accurate values. Pressure trends and
consistency among pressure measurements are the most important findings.
|
|
6 |
6 |
|
7 Evaluate the timing
and attach the tracing to the IABP record. |
7 |
|
8 Do not increase the
augmentation volume if the balloon volume has been reduced
due to aortic size. |
8 Balloons that do not
fully inflate are prone to vertical folds which can
predispose the balloon to rupture. Ideally, appropriately
size balloons are inserted that permit full inflation. Occasionally,
patients can be temporarily vasoconstricted,
necessitating balloon volume reduction. Balloon volume increases may be
possible as the patient's condition improves. |
|
9 Assess capillary
refill and left radial pulse at the start of each shift and q1h.
Notify the physician
of any change from the previous hour. Document on flow
sheet and nursing note. |
9 If the balloon
migrates too high, it can obstruct flow to the left subclavian artery.
|
|
10 Observe site and
report any signs of infection to the physician |
10 |
|
11 |
11 |
|
12 Avoid hip
flexion. Log roll or straight
lift for CXR. |
12 Raising the head of
the bed can shorten the aorta and permit migration of the IABP catheter.
Ideally, keep the HOB
elevated versus supine, to reduce risk for aspiration. |
|
13 |
13 |
|
14 |
14 |
|
15 |
15 |
|
16 Obtain an order to
change the assist interval for reasons other than timing assessment. Return the patient to
the previously tolerated assist control interval if signs of intolerance are
observed during weaning (e.g. chest pain, hypotension, arrhythmias, ST changes). Notify the physician
if signs of intolerance are identified |
16 If the patient
demonstrates evidence of myocardial ischemia/dysfunction related to weaning,
prompt correction must take place to prevent permanent myocardial injury.
|
|
17 Note that 24 fills
remain from the time when the low helium light illuminates. |
17 |
|
18 |
18 The System 98 is very
easy to initiate: ·
To switch pumps, transfer the helium line, pressure transducer and ECG
leads from the back of the malfunctioning pump to the new pump. ·
Ensure that the helium tank is open (counter-clockwise) and position
the inflation and deflation markers midposition.
·
Turn the pump on. Wait until the ready signal appears. Pumping can now be initiated. ·
For on-line help, select the "HELP" key. |
Notify the
cardiologist/cardiovascular surgeon immediately in the event of a static
balloon. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. Christenson, J.T., et al, Optimal timing of
preoperative intraaortic balloon pump support in high
risk coronary patients, Annals of Thoracic Surgery 1999; 68:934-939.
2. Christenson, J.T., et al, Preoperative intraaortic balloon pump therapy in high risk coronary
patients - impact on post operative ionotropic drug
use, Today's Therapeutic Trends 17(3);217-225, 1999.
3. Christenson, J.T., et al, Evaluation
of preoperative intra-aortic balloon pump support in high
risk coronary patients. European Journal of Cardiothoracic Surgery;11 (1997):1097-1103.
4. Christenson, J.T., et al,
Preoperative intra-aortic balloon pump enhances cardiac performance and
improves the outcome of redo CABG, Annals of
Thoracic Surgery 1997; 64: 1237-1244.
There have been Visitors to this page.
This page last updated 07/25/10All comments and questions about content at this site should
be sent to nursebob@nursebob.com
Return to Nurse Bob's® Page
Cardiology In
Critical Care
IABP Intraaortic Balloon Pump
|
IABP PRINCIPALS The IABP inflates and deflates in the patients descending aorta allowing
an increase in oxygen supply to the myocardium, decreases workload of the
left ventricle and increases cardiac output and perfusion of the vital
organs. POSITIONING
|
|
COUNTERPULSATION-HOW ITWORKS IABP TIMING Baloon Sizes |
|
Procedure |
Rationale |
|
1 The nurse assigned to
relieve for breaks will be approved to care for the
patient on the IABP. |
1 The nurse responsible
for the IABP must be able to maintain and troubleshoot the pump. |
|
2 |
2 Select the desired ECG
source from the Patient Waveform box on the IABP panel. |
|
3 Use ECG trigger for
most situations. Pressure trigger is
a suitable trigger if the ECG is temporarily lost or the patient has no ECG
rhythm and is receiving CPR. Avoid the use of the
pacemaker trigger modes. Following a change
in trigger mode, the assist button must be re-selected
to resume pumping. |
3 When using the
pressure trigger during CPR or severe hypotension,
the pressure threshold can be reduced to ensure that the pump
recognizes systolic events. Adjust by using the arrows in the auxiliary
trigger option. ECG trigger mode will
work well for patients being paced. The
pacemaker trigger modes will only work for fixed rate pacing. If the
patient is in a pacemaker trigger mode, the pump will ignore native beats and
only operate with paced impulses. |
|
4 Tape
aortic line pressure transducer to the patient level with the mid-axillary line. Check the transducer
position hourly, to ensure that it is level with the mid-axillary
line. |
Monitoring
of the aortic line by the Datascope enables rapid transport of patients while
on the IABP. The Datascope pressure
module provides an alternate BP source in the event that the bedside monitor
should fail. Avoid taping the
transducer to the IABP or mounting on the IV pole, as it is too difficult to accurately level the transducer. |
|
5 Titrate drugs to a desired MEAN BP
obtained from the Datascope monitor. Use the BP obtained from the Datascope
pump when calculating hemodynamics.* |
5 The bedside monitor
displays the SBP as the highest pressure
measured. If the balloon is
successful at augmenting the DBP above the SBP, the SBP displayed by the
bedside monitor will actually be the augmented DBP.
If augmentation is sub
optimal, the augmented pressure may not exceed the SBP...in
this case, the SBP will
remain the highest pressure and will be displayed by the bedside monitor
appropriately. The Datascope console
differentiates between the SBP, augmented pressure
and end diastolic pressure. It will also display assisted and
unassisted systole and diastole if the pump is placed
in 1:2 or 1:3. Aortic and peripheral
systolic and diastolic pressures are not necessarily the same; peripheral
arterial lines often amplify the SBP. Mean BP
will usually correlate much more closely and is a better indicator of BP.
Aortic pressure
represents the central or core BP. It is a better indicator of BP than
a peripheral arterial line, as long as the aortic line is patent and
displaying accurate values. Pressure trends and
consistency among pressure measurements are the most important findings.
|
|
6 |
6 |
|
7 Evaluate the timing
and attach the tracing to the IABP record. |
7 |
|
8 Do not increase the
augmentation volume if the balloon volume has been reduced
due to aortic size. |
8 Balloons that do not
fully inflate are prone to vertical folds which can
predispose the balloon to rupture. Ideally, appropriately
size balloons are inserted that permit full inflation. Occasionally,
patients can be temporarily vasoconstricted,
necessitating balloon volume reduction. Balloon volume increases may be
possible as the patient's condition improves. |
|
9 Assess capillary
refill and left radial pulse at the start of each shift and q1h.
Notify the physician
of any change from the previous hour. Document on flow
sheet and nursing note. |
9 If the balloon
migrates too high, it can obstruct flow to the left subclavian artery.
|
|
10 Observe site and
report any signs of infection to the physician |
10 |
|
11 |
11 |
|
12 Avoid hip
flexion. Log roll or straight
lift for CXR. |
12 Raising the head of
the bed can shorten the aorta and permit migration of the IABP catheter.
Ideally, keep the HOB
elevated versus supine, to reduce risk for aspiration. |
|
13 |
13 |
|
14 |
14 |
|
15 |
15 |
|
16 Obtain an order to
change the assist interval for reasons other than timing assessment. Return the patient to
the previously tolerated assist control interval if signs of intolerance are
observed during weaning (e.g. chest pain, hypotension, arrhythmias, ST changes). Notify the physician
if signs of intolerance are identified |
16 If the patient
demonstrates evidence of myocardial ischemia/dysfunction related to weaning,
prompt correction must take place to prevent permanent myocardial injury.
|
|
17 Note that 24 fills
remain from the time when the low helium light illuminates. |
17 |
|
18 |
18 The System 98 is very
easy to initiate: ·
To switch pumps, transfer the helium line, pressure transducer and ECG
leads from the back of the malfunctioning pump to the new pump. ·
Ensure that the helium tank is open (counter-clockwise) and position
the inflation and deflation markers midposition.
·
Turn the pump on. Wait until the ready signal appears. Pumping can now be initiated. ·
For on-line help, select the "HELP" key. |
Notify the
cardiologist/cardiovascular surgeon immediately in the event of a static
balloon. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. Christenson, J.T., et al, Optimal timing of
preoperative intraaortic balloon pump support in high
risk coronary patients, Annals of Thoracic Surgery 1999; 68:934-939.
2. Christenson, J.T., et al, Preoperative intraaortic balloon pump therapy in high risk coronary
patients - impact on post operative ionotropic drug
use, Today's Therapeutic Trends 17(3);217-225, 1999.
3. Christenson, J.T., et al, Evaluation
of preoperative intra-aortic balloon pump support in high
risk coronary patients. European Journal of Cardiothoracic Surgery;11 (1997):1097-1103.
4. Christenson, J.T., et al,
Preoperative intra-aortic balloon pump enhances cardiac performance and
improves the outcome of redo CABG, Annals of
Thoracic Surgery 1997; 64: 1237-1244.
There have been Visitors to this page.
This page last updated 07/25/10All comments and questions about content at this site should
be sent to nursebob@nursebob.com
Return to Nurse Bob's® Page
Cardiology In Critical
Intra Aortic Balloon Pump
Patient Information
Your heart is a muscular pump with a demanding job. It must continually pump
blood to every part of your body. The blood supplies oxygen, the fuel needed to
support your body tissues and their functions.
Once your body’s tissues have taken the oxygen they need, the oxygen-depleted
blood is returned to the two chambers on the right
side of your heart. These chambers are responsible for pumping the
oxygen-depleted blood into the lungs. In the lungs the
blood is replenished with a fresh supply of oxygen and returned to the left
side of your heart.
On the left side of your heart, two chambers are responsible for pumping the
newly-oxygenated blood throughout your body once
again. This oxygen-rich blood leaves your heart through the largest artery in
your body, the aorta.
Of course, your heart needs its own continuous supply of fuel. This supply
line of oxygen-rich blood begins a the base of the
aorta, and surrounds your heart muscle in the same way the fingers of your hand
wrap around a ball. This network of supply lines is called
your coronary arteries.
When the heart does not have enough oxygen due to blocked coronary arteries,
or other medical problems, the heart must work harder to provide the needed
oxygen. Intra-aortic balloon pump therapy helps restore the balance between the
supply of oxygen-rich blood the heart receives from the coronary arteries, and the amount of oxygen the heart needs to pump.
This therapy involves two components. One is a thin balloon
which is positioned within your aorta after being introduced through an
artery. The second component of balloon pump therapy is the pump itself. The
pump continually inflates and deflates the balloon within your aorta in time
with your heart beat.
The intra-aortic balloon pump assists your heart during both its rest phase
and its work phase. In the rest phase, the balloon inflates, increasing the
supply of oxygen-rich blood to the coronary arteries. In the work phase, the
balloon deflates, decreasing the workload on your heart.
The decrease in workload results in a decrease in the
amount of oxygen the heart needs to pump.
As blood is pumped,
your heart is at work.
During the work phase, your heart pumps oxygen-rich blood into the aorta and
out to the far reaches of your body. This task requires a large amount of oxygen.
At the end of each work phase your heart has used up a large portion of the
oxygen it has been given.
As chambers fill, your heart is at
rest.
Your heart is in its rest phase as the chambers are filling, preparing to pump
more blood. During this phase your heart muscle is
able to relax. While it is resting, it is receiving a fresh supply of
oxygen-rich blood through your coronary arteries.
When the balloon deflates, your
heart’s workload is reduced.
Just before your heart gets ready to work, the balloon within your aorta
deflates. This deflation results in a drop in pressure in the aorta, so that
when your heart pumps it doesn’t have to work
against high pressure. Instead, your heart’s workload is
actually reduced, and blood is pumped throughout your body more easily.
When the balloon inflates, your
heart receives more oxygen.
When your heart is in its rest phase, and receiving its fresh supply of blood,
the balloon placed within your aorta is inflated by the pump
at your bedside. This process pushes more oxygen-rich blood through your
coronary artery supply network and into your heart’s muscle tissue,
providing your tired heart with extra energy for its work phase.
Relax…
Help us help you by keeping calm and making us aware of any changes in your
condition.
Cough and deep breathe frequently
Report any chest pain or heaviness to a nurse or
physician.
Report any pain, numbness, or tingling to a nurse or physician.
Bed rest is important…
Don’t sit up, attempt to get out of bed, or flex or bend the leg in which
the balloon catheter is inserted, as these activities can interfere with the
proper functioning of the balloon.
And…
Don’t be concerned when the balloon pump stops, because your heart is
continuously beating for itself. At pre-programmed intervals, the balloon pump
will stop pumping for a brief period of time. Your
heart will continue pumping. And remember too, that a
nurse or health care professional trained in the operation of the balloon pump
will be monitoring the machine throughout your period of therapy.
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