Complications of Intra-aortic Balloon Pumping: Preventable or Not Preventable?

Intraaortic Balloon Pumping Through the Common Iliac Artery: Management of the Ambulatory Intraaortic Balloon Pump Patient

“…Although the common iliac artery has a larger diameter than the femoral artery and the use of iliac artery insertion may be of benefit to the patient with severe peripheral vascular disease, it is important to assess patients for signs and symptoms associated with limb ischemia. Limb ischemia can be caused by acute thrombosis, embolization, arterial injury or disruption, existing peripheral vascular disease, poor cardiac output, mechanical obstruction by the catheter, pseudoaneursym, or vessel spasm 14 . Risk factors associated with the development of limb ischemia include female sex, preexisting peripheral vascular disease, diabetes mellitus, hypertension, prolonged duration of use, larger balloon diameter, and left ventricular pump failure as the indication for IABP use 28 .…”

“…Mild thrombocytopenia (platelet count=75,000–149,000) has been reported in as many as 47% of IABP patients 30 . Platelet destruction is most often caused by mechanical action of the IABP 14,30 . This mild thrombocytopenia is not related to clinical bleeding 30 .…”

“…This mild thrombocytopenia is not related to clinical bleeding 30 . Monitoring of hemoglobin and hematocrit, platelets, and coagulation studies including activated partial thromboplastin time (aPTT) as well as maintaining anticoagulation therapy at therapeutic levels is essential 14,24 . Inspection of urine, gastrointestinal secretions, emesis, and stool for occult blood is also recommended 14 .…”

“…Monitoring of hemoglobin and hematocrit, platelets, and coagulation studies including activated partial thromboplastin time (aPTT) as well as maintaining anticoagulation therapy at therapeutic levels is essential 14,24 . Inspection of urine, gastrointestinal secretions, emesis, and stool for occult blood is also recommended 14 . If heparin induced thrombocytopenia is suspected, the patient should be tested for heparin dependent antibodies.…”

“…If heparin induced thrombocytopenia is suspected, the patient should be tested for heparin dependent antibodies. If present, heparin should be discontinued 14 …”