Device Procedures

IABP,

Intra-Aortic Balloon Pump (IABP)

temporary circulation support device helping help when it can’t pump properly

IABP Process

• Balloon inserted via femoral artery going into thoracic aorta (Confirm with X-ray placement)

• Balloon inflate during diastole : receives most of the blood and when the balloon inflates the blood is pushed which increases the coronary perfusion and helps blood reach the organs.

• Balloon deflates JUST BEFORE SYSTOLE: created more space in aorta, LV has less resistance to eject blood

Inflate to feed coronary arteries

Deflate BEFORE systole to eject out of LV

Nursing Care IABP

circulation/Perfusion Monitoring

• peripheral pulses

• skin color

• temp

• signs of limb ischemia

• renal perfusion/urine output

Positioning: keep immobile, supine or side lying, HOB <45

IABP Complications

Limb Ischemia: cold pale lung with weak/absent pulse compromised blood flow

• vascular injury

• thrombus

• embolus

• peripheral nerve damage

• kidney, bowel ischemia

IABP Weaning

• gradual reduce the assist ratio

• 1:1→ 1:2 → 1:3

Ventricular Assist Device (VAD)

mechanical support to ventricle that can’t pump efficiently; ventricle is weak able to assist ventricle to pump blood forward

• placement: implanted internally, positioned externally

VAD indications

1. failure to wean of bypass

2. HF after MI

3. Bridge during heart transplant

VAD Nursing Interventions

• Mobile

• frequently assess pt

Comparison Table IABP vs VAD

	IABP	VAD
What it does	Assists circulation indirectly	Mechanically pumps blood
Main goal	Improve perfusion + ↓ workload	Support failing ventricle
Temporary?	Yes	Can be temporary/longer-term
Bridge to transplant	Not main PPT indication	Yes
Patient mobility	Very limited	May be mobile
Major nursing focus	Vascular perfusion	Device + patient assessment/education

IABP= helps HEART pump

VAD= helps BLOOD to be pumped