Intraaortic balloon counterpulsation/secondary school (nurse)


 * A method of temporary mechanical support of hemodynamics, designed primarily for the treatment of cardiogenic shock in cases where catecholamine therapy fails.
 * In balloon counterpulsation (IABP), there is a regular, heart-cycle-synchronized expansion and emptying of a long balloon with helium, which is located in the upper region of the descending aorta:
 * → in diastole, the balloon is inflated → an increase in blood pressure in front of the balloon, an increase in the flow věnčitými tepnami;
 * → at the beginning of systole, the balloon is emptied → a decrease in outflow resistance → an increase in the flow through the aorta.

Effect of IABP

 * Reduction of cardiac load;
 * increasing the supply of nutrients to the heart muscle;
 * reducing myocardial oxygen consumption (by increasing the minute volume, slowing the heart rate).

Indication
→ important early start, before the complete collapse of circulation.
 * Cardiogenic shock;
 * acute coronary syndrome unresponsive to standard therapy;
 * low cardiac output syndrome;
 * cardiac surgical operations;
 * support in ECMO;
 * septic or anaphylactic shock − circulatory support:
 * „Preventive“ introduction before cardiac surgery in extremely high-risk patients or before major surgery of another type in cardiac patients in advanced heart disease.

Contraindications

 * Thrombolytic therapy;
 * septic state;
 * atherosclerosis obliterans;
 * aortic regurgitation;
 * trauma of the aorta;;
 * aortic aneurysm.

Complications

 * Ischemia of the lower extremities (thromboembolism);
 * the emergence of infection;
 * aortic rupture;
 * thrombocytopenia;
 * technical – balloon rupture, gas leakage, device failure.

Prevention

 * IABP only the necessary time;
 * inspection of the lower extremities;
 * bandage of the injection site after removal of the cannula.