Pulmonary edema interventional therapy: Difference between revisions
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==Overview== | ==Overview== | ||
[[ | [[Intra-aortic balloon pump]] can be used to achieve hemodynamic stabilization in the patient before definitive therapyIt consists of a cylindrical balloon that sits in the [[aorta]] and counterpulsates. That is, it actively deflates in [[systole]] increasing forward blood flow by reducing [[afterload]], and actively inflates in [[diastole]] increasing blood flow to the [[Coronary artery|coronary arteries]]. | ||
==Interventional Therapy== | ==Interventional Therapy== | ||
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* The [[intra-aortic balloon pump]] decreases afterload | * The [[intra-aortic balloon pump]] decreases afterload | ||
* The intra-aortic balloon pump is inserted [[percutaneously]] through the [[femoral artery]] | * '''Procedure''': | ||
** The intra-aortic balloon pump is inserted [[percutaneously]] through the [[femoral artery]] | |||
* The distal end of the pump is placed distal to the aortic knob and the origin of the [[left subclavian artery]] | ** The distal end of the pump is placed distal to the aortic knob and the origin of the [[left subclavian artery]] | ||
* For inflation of the balloon [[helium]] is used | ** For inflation of the balloon [[helium]] is used | ||
* Inflation of the balloon should occur in early [[diastole]], just after the aortic valve closes | ** Inflation of the balloon should occur in early [[diastole]], just after the aortic valve closes | ||
* Deflation of balloon should occur in early [[systole]], just before the [[aortic valve]] opens | ** Deflation of balloon should occur in early [[systole]], just before the [[aortic valve]] opens | ||
* Proper inflation results in an assisted peak [[diastolic pressure]] higher than the unassisted peak systolic arterial pressure | * Proper inflation results in an assisted peak [[diastolic pressure]] higher than the unassisted peak systolic arterial pressure | ||
* Proper deflation leads to assisted aortic end-diastolic pressure of approximately 10mm Hg lower than the unassisted end-diastolic pressure | * Proper deflation leads to assisted aortic end-diastolic pressure of approximately 10mm Hg lower than the unassisted end-diastolic pressure | ||
Latest revision as of 13:30, 16 March 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]
Overview
Intra-aortic balloon pump can be used to achieve hemodynamic stabilization in the patient before definitive therapyIt consists of a cylindrical balloon that sits in the aorta and counterpulsates. That is, it actively deflates in systole increasing forward blood flow by reducing afterload, and actively inflates in diastole increasing blood flow to the coronary arteries.
Interventional Therapy
Intra-Aortic Balloon Pumping
- Can be used to achieve hemodynamic stabilization in the patient before definitive therapy[1]
- The intra-aortic balloon pump decreases afterload
- Procedure:
- The intra-aortic balloon pump is inserted percutaneously through the femoral artery
- The distal end of the pump is placed distal to the aortic knob and the origin of the left subclavian artery
- For inflation of the balloon helium is used
- Inflation of the balloon should occur in early diastole, just after the aortic valve closes
- Deflation of balloon should occur in early systole, just before the aortic valve opens
- Proper inflation results in an assisted peak diastolic pressure higher than the unassisted peak systolic arterial pressure
- Proper deflation leads to assisted aortic end-diastolic pressure of approximately 10mm Hg lower than the unassisted end-diastolic pressure
Contraindications
Absolute contraindications for intra-aortic balloon pumping include:
- Dissecting aortic aneurysm
- Severe aortic regurgitation
- Large arteriovenous shunt
- Severe coagulopathy
Relative contraindications include:
- Severe peripheral vascular disease
- Recent thrombolytic therapy
- Bleeding diathesis
- Descending aortic
- Peripheral vascular grafts
References