IABP augmentation

Specialties CCU

Published

I'm having a hard time understanding exactly what the augmentation is. i have taken a couple of balloon pump classes and researched online, but I'm still having a difficult time understanding. Can someone explain this simply please?

Specializes in ICU/CCU/CVICU.

My understanding is this: per an art line waveform the balloon begins to inflate at the dicrotic notch which signals closure of the aortic valve and the beginning of ventricular diastole. The augmentation pressure is the pressure in mmHg of pressure generated by the balloon when it inflates during diastole. The coronary arteries are perfused during diastole and the extra pressure helps force more blood flow through the coronary arteries this augmenting the pts own flow and improving myocardial oxygenation.

Thank you :) I was reading into it way too much.

Specializes in CTICU.

Ideally-timed IABPs do two things: inflate and push extra blood to the coronaries in diastole (improve myocardial perfusion) and deflate right before ventricular systole to reduce the workload of the ventricle (reduce myocardial oxygen demand). Sometimes you get one more than the other, but which is more important depends on the indication for the IABP insertion ie. for cardiogenic shock, the workload reduction may be more important, while for an MI the improved perfusion may be more important.

If your pt is on IABP, do you titrate medications to the art line pressure or to the assisted pressures on the pump?

Specializes in ICU/CCU/CVICU.

I usually titrate to the mean art pressure on the balloon pump unless there is an order stating otherwise.

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