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IABP TIMING

POCKET REFERENCE GUIDE


CORRECT IABP TIMING

R
P
T

Q S
C D

A One complete cardiac cycle F


B Unassisted aortic end diastolic pressure
C Unassisted systolic pressure
B
D Diastolic augmentation
Reduced aortic end diastolic pressure A E
E

F Reduced systolic pressure


INFLATION
At the onset of diastole, IAB inflation occurs,
giving rise to sharp “V” on arterial waveform
Effect:
Increased coronary perfusion

DEFLATION

Occurs at end of diastole prior to systole


resulting in reduction of aortic end-diastolic
and systolic pressures
Effects:
Please Note: R-Wave deflation Decreased afterload
may provide more effective Decreased cardiac work
support for patients experiencing Decreased myocardial oxygen consumption
arrhythmias. Increased cardiac output
INCORRECT IABP TIMING
Inflation of the IAB prior to aortic valve closure EARLY INFLATION
Waveform characteristics:
Diastolic Augmentation
Inflation of IAB prior to dicrotic notch
Diastolic augmentation encroaches onto
systole (may be unable to distinguish)
Unassisted
systole Assisted
Physiologic effects:
Systole
Potential premature closure of the aortic valve
Potential increase in LVEDV and LVEDP
or PCWP
Increased left ventricular wall stress
or afterload
Aortic regurgitation
Increased MV02 demand Dicrotic
Notch
Inflation of the IAB markedly after LATE INFLATION
closure of the aortic valve
Diastolic Augmentation
Waveform Characteristics:
Inflation of IAB after the dicrotic notch Unassisted
Assisted
Systole
Absence of sharp V Systole

Physiologic Effects:
Sub-optimal coronary artery perfusion

Aortic Valve
Closes Dicrotic Notch
INCORRECT IABP TIMING
Premature deflation of the IAB during the
EARLY DEFLATION
diastolic phase
Diastolic Augmentation
Waveform Characteristics:
Deflation of IAB is seen as a sharp drop
following diastolic augmentation Assisted Systole
Sub-optimal diastolic augmentation
Assisted aortic end diastolic pressure may
be equal to or less than the unassisted aortic
end diastolic pressure
Assisted systolic pressure may rise

Physiologic Effects:
Sub-optimal coronary perfusion
Potential for retrograde coronary and carotid
blood flow
Sub-optimal afterload reduction Unassisted End Assisted End
Diastolic Pressure Diastolic Pressure
Increased MV02 demand
Waveform Characteristics: LATE DEFLATION
Assisted aortic end diastolic pressure may
be equal to the unassisted aortic end
diastolic pressure Diastolic
Augmentation
Rate of rise of assisted systole is prolonged
Diastolic augmentation may appear widened

Physiologic Effects:
Afterload reduction is essentially absent
Increased MV02 consumption due to the
left ventricle ejecting against a greater
resistance and a prolonged isovolumetric Assisted
contraction phase End Diastolic Pressure
IAB may impede left ventricular ejection and
Unassisted End Diastolic Pressure
increase the afterload
ARTERIAL PRESSURE MONITORING
THROUGH THE IAB INNER LUMEN

Transducer Setup
Inner Lumen Care
Transducer Setup

≤ 5' Preferred
8' Maximum

A Minimize length of pressure tubing C Do not use a damping D Use gravity fill to minimize
device (e.g. R.O.S.E. air bubbles
B Use only high stiffness pressure
resonance overshoot E Elevate flush bag above
tubing (as provided by MAQUET)
eliminator) transducer
Inner Lumen Care

A Before pumping, after


insertion, gently aspirate
& discard 3cc of blood &
manually flush immedi- (3 - 5cc)
ately with 3 – 5cc of flush
solution

B A
 3cc/hour continuous C If the central lumen becomes damped: D D
 o not
flow through the inner aspirate & discard 3cc of blood sample blood
lumen is recommended ≤ 5'the
fast flush to clear Preferred
pressure tubing from the inner
continue flushing for at least 15 seconds lumen
8' Maximum
CLINICAL REFERENCE SIZING CHART NEW

cc
50cc
50
25cc 34cc 40cc
Approx. Height: ≥ 5'4" MEGA 50cc
(≥ 162cm) Approx. ht: < 5'0" Approx. ht: 5'0" to 5'4" Approx. ht: 5'4" to 6'0" Approx. ht: ≥ 5'4"
(< 152cm) (152cm - 162cm) (162cm - 183cm) (≥ 162cm)
cc
40

Approx. Height: From 5'4" - 6' 6'

(162 cm - 183 cm)


5'
cc
34
4'
Approx. Height: From 5' - 5'4"
(152 cm - 162 cm)
Note: This
information is
cc
25 to be used as a
guidance only.
Clinical information
Approx. Height: < 5' and patient factors

(< 152 cm) such as torso length


should be considered
when selecting the
appropriate balloon
size.
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that contribute to quality enhancement and cost efficiency within healthcare
and life sciences. We operate under the three brands of ArjoHuntleigh,
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Fax: +1 800 258 8762
Tel: +1 973 244 6100
® MAQUET Registered Trademark of MAQUET GmbH & Co. KG · Copyright MAQUET
Fax: +1 973 244 6279 Cardiovascular LLC or its affiliates. All rights reserved. 09/09 Caution: U.S. Federal
Law restricts this device to sale by or on the order of a physician. Refer to package insert
for current indications, warnings, contraindications, precautions and instructions for use.
http://ca.maquet.com 8/10 MCV-BR-80000301-EN-02 P/N: 0002-08-0307 R5 1Data on file

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