Pulmonary edema interventional therapy: Difference between revisions
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===Intra-Aortic Balloon Pumping=== | ===Intra-Aortic Balloon Pumping=== | ||
* Can be used to achieve hemodynamic stabilization in the patient before definitive therapy<ref name="pmid6336469">{{cite journal |vauthors=Stamatelopoulos S, Economides K, Harhalakis N, Adamopoulos S, Saridakis N, Antoniou A, Chaniotis F, Moulopoulos S |title=Effect of intraaortic balloon pumping on pulmonary edema in a low compliance high volume model |journal=Life Support Syst |volume=1 Suppl 1 |issue= |pages=9–12 |date=1983 |pmid=6336469 |doi= |url=}}</ref> | * Can be used to achieve hemodynamic stabilization in the patient before definitive therapy<ref name="pmid6336469">{{cite journal |vauthors=Stamatelopoulos S, Economides K, Harhalakis N, Adamopoulos S, Saridakis N, Antoniou A, Chaniotis F, Moulopoulos S |title=Effect of intraaortic balloon pumping on pulmonary edema in a low compliance high volume model |journal=Life Support Syst |volume=1 Suppl 1 |issue= |pages=9–12 |date=1983 |pmid=6336469 |doi= |url=}}</ref> | ||
* 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 | * The intra-aortic balloon pump is inserted [[percutaneously]] through the [[femoral artery]] | ||
* The distal end of the pump is placed | * 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 | ||
==== Contraindications ==== | ==== Contraindications ==== | ||
Absolute contraindications for intra-aortic balloon pumping include: | Absolute contraindications for intra-aortic balloon pumping include: | ||
* Dissecting aortic aneurysm | * [[Aortic aneurysm - dissecting|Dissecting aortic aneurysm]] | ||
* Severe aortic regurgitation | * Severe [[aortic regurgitation]] | ||
* Large arteriovenous shunt | * Large [[Arteriovenous shunts|arteriovenous shunt]] | ||
* Severe coagulopathy | * Severe [[coagulopathy]] | ||
Relative contraindications include: | Relative contraindications include: | ||
* Severe peripheral vascular disease | * Severe [[peripheral vascular disease]] | ||
* Recent thrombolytic therapy | * Recent thrombolytic therapy | ||
* Bleeding diathesis | * [[Bleeding diathesis]] | ||
* Descending aortic | * Descending aortic | ||
* Peripheral vascular grafts | * Peripheral vascular grafts | ||
Revision as of 17:15, 8 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
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
- 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