Re: Anybody ever see an IABP balloon failure?

Originally Posted by ghillbert

Complications from many things in critical care can be lethal, but that doesn't necessarily make them require 1:1. Nor should any piece of equipment - that patient's condition should dictate the level of care required. Like anything else, monitoring is what will identify a problem - ruptured balloons are not common (0-6% is the data I just read) and gas emboli resulting from a ruptured balloon is significantly rarer.

A stable patient on ventilator, IABP, CRRT, inotropes... all of them can die if something goes wrong. The incidence of unplanned extubation far outweighs that of IABC rupture and many places don't have 1:1 care of mechanically vented patients.

Staffing level is of course immensely important. The important thing is education of staff to recognize the signs and symptoms of device complications - even if you're 1:1, you'd better turn that IAB console off fast if you get low pressure/helium leak alarms and/or see blood in the tubing.

Agree completely, ghillbert. Pt condition should dictate staffing levels, along with the staff experience. We would have experienced RNs in the IABP rooms in a 1:1 assignment, but then they would resource for new hires or less exp RN's if the pt was stable. We also tried to get the new hires in the IABP assignments and have another RN resource. Anyway- we tried to keep patients safe, staff happy, and foster a psotive working enviroment--sappy sappy, love, love---but its true

Re: Anybody ever see an IABP balloon failure?

On my unit, the staffing compromise is to have that balloon pump 1:1 for the first six hours or so, then if they are stable you would be given a second stable pt. That way, you have six hours to get all the tubes & lines in, stabilize the pt, and get all the paperwork & charting caught up. It works really well for us.

Re: Anybody ever see an IABP balloon failure?

Wow.... iabp 1:1, never where i worked for eight years. how about one pt with a balloon(no perfusionist) an your other on cvvhd.

Re: Anybody ever see an IABP balloon failure?

Why on earth would you need a perfusionist for an IABP? It's not like it's ECMO.

Re: Anybody ever see an IABP balloon failure?

dear all,
i would like to ask how s the IABP works ? why inflating the ballon in the diastole can increase the coronary artery perfusion ?

thank you

Re: Anybody ever see an IABP balloon failure?

Might be better of starting your own thread about that.

Basically, inflating in diastole helps by pushing blood through the coronaries (coronaries perfuse during diastole). Deflating in systole creates a sort of vacuum that means the heart pumps into lower pressure and doesn't have to work so hard. Overall: increased myocardial oxygenation and decreased myocardial oxygen demand.

As an added extra, you get better perfusion to your head and kidneys as well.

Re: Anybody ever see an IABP balloon failure?

thank you so much