Intra-Aortic Balloon Pump Insertion

[waterski232002]

How do you do Insert an Intra-Aortic Balloon Pump? Is it the same as inserting a large Arterial Cordis and then sliding the IABP through. Any advice or tips/tricks? What good resources are there for reading about the procedure?

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[Qtip96]

How do you do Insert an Intra-Aortic Balloon Pump? Is it the same as inserting a large Arterial Cordis and then sliding the IABP through. Any advice or tips/tricks? What good resources are there for reading about the procedure?

i don't think this forum is the appropriate place to learn about how to insert IABPs. you really should be learning IABP placement under fluoro with supervision. the mechanics are pretty straight forward, but the devil is in the details, and rooted in good overall cath technique.

for example, with access. arterial access is typically single pass modified seldinger. double passing through the posterior wall can lead to retroperitoneal bleeding in a heparinized patient at a non-compressible site (if cephalad to the pelvic brim). any stick too far caudal, and you could cannulate the profunda femoris bifurcation leading to major vascular injury and possibly limb ischemia. the reason this is so important is because the IABP is typically >= 8French, which can do a lot of damage (our angiographies are performed with 6F introducers). the patient demographics for IABPs is also comorbid with vasculopathy. even in the cath lab with fluoro we are meticulous about access, which is one of the primary sources of complications. and that's just the beginning...

aside from the actual mechanics of IABP placement the real humdinger is nursing support. you're not going to get very far trying to place IABPs if the nurses are not experienced in setting it up and maintaining it (like in the cath lab, OR, CCU, or CT ICU). i'm sorry to say that i strongly think IABPs are better off being placed by the on-call cath team.

also, wouldn't you be a little incredulous about someone asking for technical advice about an invasive procedure on a public web forum?

 

[Noyac]

i don't think this forum is the appropriate place to learn about how to insert IABPs. you really should be learning IABP placement under fluoro with supervision. the mechanics are pretty straight forward, but the devil is in the details, and rooted in good overall cath technique.

for example, with access. arterial access is typically single pass modified seldinger. double passing through the posterior wall can lead to retroperitoneal bleeding in a heparinized patient at a non-compressible site (if cephalad to the pelvic brim). any stick too far caudal, and you could cannulate the profunda femoris bifurcation leading to major vascular injury and possibly limb ischemia. the reason this is so important is because the IABP is typically >= 8French, which can do a lot of damage (our angiographies are performed with 6F introducers). the patient demographics for IABPs is also comorbid with vasculopathy. even in the cath lab with fluoro we are meticulous about access, which is one of the primary sources of complications. and that's just the beginning...

aside from the actual mechanics of IABP placement the real humdinger is nursing support. you're not going to get very far trying to place IABPs if the nurses are not experienced in setting it up and maintaining it (like in the cath lab, OR, CCU, or CT ICU). i'm sorry to say that i strongly think IABPs are better off being placed by the on-call cath team.

also, wouldn't you be a little incredulous about someone asking for technical advice about an invasive procedure on a public web forum?

Just curious Q, what's your background? Anesthesia? Cards? You can PM me if you don't want to respond here.

 

[waterski232002]

also, wouldn't you be a little incredulous about someone asking for technical advice about an invasive procedure on a public web forum?

Of course... I definitely take what is said here with a large grain of salt, and a slanted eye. But it's a good forum to bounce around ideas, and there are some posters on here who's opinions I do regard very highly.

I appreciate your feedback... it's nice to get the other perspective, that's why I posted it in the cardiology forum as well as the EM forum. If I only ask for the EM perspective, than I will get a bias discussion.

Thanks

 

[Qtip96]

Of course... I definitely take what is said here with a large grain of salt, and a slanted eye. But it's a good forum to bounce around ideas, and there are some posters on here who's opinions I do regard very highly.

I appreciate your feedback... it's nice to get the other perspective, that's why I posted it in the cardiology forum as well as the EM forum. If I only ask for the EM perspective, than I will get a bias discussion.

Thanks

hey, no worries dude. good luck to ya.