[bullseye]

Does anyone know how to calculate afterload and augmentation when a patient is on the an IABP? If anyone has any ideas kindly let me know. Thanks. Bullseye

[suzanne4]

Moved your thread to the Critical Care forums as it does not have anything to do with medications.

Much has been written on this in the past, suggest that you just do a search for it here.

[MarkHammerschmidt]

Sure. Afterload is just SVR, which you get from your PA line numbers. Augmentation you measure manually on a printout, or by using a cursor on a screen-freeze, it's the difference between the patient's systolic peak and the "assisted" systolic peak, after the ballooned beat. Take a look at www.icufaqs.org, we have a nice article up about balloons.

[ghillbert]

Which type of IABP? Either way, in order to see diastolic augmentation when you're in 1:1 support, you need to switch to 1:2 and then freeze the screen. You can then move the cursor up to the augmented diastole on the screen and read the numbers off. Once the screen is frozen, switch back to 1:1 support.

Someone should be documenting the balloon pressures regularly in any case: unassisted systole, augmented diastole, balloon-assisted end diastolic pressure, assisted systole, patient end diastolic pressure. Documenting the pressures allows you to optimize balloon timing.

YOu can check the websites of the manufacturers for educational material. You should also have someone on your floor who is an expert at these devices.