Blood Pressure Monitoring During Intra-Aortic Balloon Pumping

Knippa, Sara

doi:10.4037/ccn2019675

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Current guidelines advocate for maintaining a MAP of at least 70 mmHg to mitigate the risk of hypoperfusion [ 10 ]. However, the literature remains deficient in studies comparing different MAP monitoring techniques in CS patients who are undergoing IABP therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, mean arterial pressure (MAP) may also be subject to distortions depending on the monitor's algorithm. Moreover, the conventional arithmetic calculation for MAP (i.e., (SBP + 2*DBP)/3) does not accurately represent the effect of balloon-assisted diastolic augmentation [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Accurate blood pressure monitoring is indispensable for CS patients undergoing IABP therapy, as it imparts critical insights into the hemodynamic status and informs therapeutic decision- making [ 10 ]. Notably, the impact of blood pressure monitoring on patients undergoing IABP therapy has not been elucidated in prior research.…”

Section: Introductionmentioning

confidence: 99%

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Discrepancy between two invasive blood pressure measurements in patients receiving intra-aortic balloon pump therapy

Lu,

Zhang,

Zhang

et al. 2023

BMC Cardiovasc Disord

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Background Hemodynamic monitoring is imperative for patients with cardiogenic shock undergoing Intra-aortic Balloon Pump (IABP) therapy. Blood pressure monitoring encompasses non-invasive, invasive peripheral arterial pressure (IPAP), and invasive central aortic pressure (ICAP) methods. However, marked disparities exist between IPAP and ICAP. This study examined the discrepancies between IPAP and ICAP and their clinical significance. Methods A retrospective analysis was conducted on cardiogenic shock patients who underwent IABP therapy and were admitted to the Coronary Care Unit (CCU) of a tertiary hospital in China from March 2017 to November 2022. The Bland–Altman plot illustrated the discrepancy between IPAP and ICAP. A clinically significant difference between ICAP and IPAP measurements was defined as ≥ 10 mmHg, which could necessitate alterations in blood pressure management according to current guidelines that recommend maintaining a mean arterial pressure (MAP) ≥ 70 mmHg. Results In total, 162 patients were included in the final analysis. In patients without vasopressors, the difference between ICAP and IPAP was 5.73 mmHg (95% limits of agreement [LOA], -16.98 to 28.44), whereas, in patients with vasopressors, it was 4.36 mmHg (95% LOA, -17.31 to 26.03). ICAP measurements exceeded IPAP in patients undergoing IABP therapy. However, the difference was not statistically significant between the two groups. Multivariate logistic regression revealed that higher serum lactate levels (Odds ratio [OR], 1.14; 95% confidence interval [CI], 1.03–1.27; p = 0.013) and age ≥ 60 years (OR, 13.20; 95% CI, 1.50–115.51; p = 0.020) were associated with an increased likelihood of a clinically significant MAP discrepancy. Conversely, a history of coronary heart disease was associated with a decreased likelihood (OR, 0.34; 95% CI, 0.13–0.90; p = 0.031). Conclusions Notable discrepancies between ICAP and IPAP measurements exist in cardiogenic shock patients undergoing IABP therapy. ICAP exceeds IPAP, and factors such as age ≥ 60 years, elevated lactic acid levels, and absence of coronary heart disease contribute to this discrepancy. Enhanced vigilance is warranted for these patients, and the consideration of peripheral invasive monitoring in conjunction with IABP therapy is advised.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Discrepancy between two invasive blood pressure measurements in patients receiving intra-aortic balloon pump therapy

Lu,

Zhang,

Zhang

et al. 2023

BMC Cardiovasc Disord

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Comparison of Noninvasive and Invasive Blood Pressure Measurements in Patients with Intra-Aortic Balloon Pumps

Parr¹,

Schaffer²

2020

ASAIO Journal

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Intra-aortic balloon pumps in cardiogenic shock: an overview

O'Donovan

2021

British Journal of Cardiac Nursing

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The intra-aortic balloon pump was first introduced for the treatment of cardiogenic shock. It is now the most commonly used form of circulatory support, despite disappointing findings from the intra-aortic balloon pump SHOCK II trial ( Thiele et al, 2012 ). Common placement is via the femoral artery into the aorta, with the tip of the balloon sitting below the left subclavian artery and the distal end above the renal arteries. The balloon is timed to inflate at the beginning of diastole augmenting coronary perfusion and deflate on the R wave just before systole, reducing the afterload. Patients who may be considered for intra-aortic balloon pump insertion are those experiencing ST elevation myocardial infarction or complex ischaemic disease and cardiogenic shock. Despite advances in catheter size and technology, potential complications include bleeding from the insertion site, limb ischaemia and compartment syndrome. Cardiovascular nurses require specialist knowledge and skills concerning balloon console technology, nursing care and potential complications.

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Blood Pressure Monitoring During Intra-Aortic Balloon Pumping

Cited by 3 publications

References 10 publications

Discrepancy between two invasive blood pressure measurements in patients receiving intra-aortic balloon pump therapy

Discrepancy between two invasive blood pressure measurements in patients receiving intra-aortic balloon pump therapy

Comparison of Noninvasive and Invasive Blood Pressure Measurements in Patients with Intra-Aortic Balloon Pumps

Intra-aortic balloon pumps in cardiogenic shock: an overview

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