IABP 101: Preparation and Insertion

Bill– showing us the guidewire and dilator coming together…

Editors Note:

This is a three part series- “IABP 101” designed to simply refresh or introduce the basic concepts of applying diastolic augmentation for the high risk cardiac patient. Again, some of the concepts here will seem to be fairly rudimentary for a seasoned perfusionist, but if it’s your first day in a perfusion program- then elementary reverts to elemental- as in a prerequisite foundation for any training program delivered to perfusionists.

This section details preperation and insertion of the IABP- more information is available at the manufacturer’s website:

A shout-out to Bill and Kim– who are in the lead role at this institution (in terms of managing the IABP’s as well as in-servicing the CCL staff). Nicely done!

Have an excellent day!

Frank

IABP: Parts & Pieces

Guide Wires INTRODUCER

Guide Wires IABP

USE ONLY for Sheathless Insertion

IABP- Sizing, Placement, and Insertion

Sheath or Sheathless?

Sizing The IABP

Preparing the IABP

Aspirate 30cc to ensure IABP is collapsed- DO NOT remove one-way valve!

Remove stylette from inner lumen: DO NOT replace stylette

Place stopcock on luer port and flush with 3-5 cc NSS. DO NOT allow air to enter!

Placement

Use the Blue T Handle as a marker for proper positioning- usually between the 2nd and 3rd intercostal space…

The balloon should be located in the proximal descending aorta, just below the origin of the left subclavian artery. This ideally results in the balloon terminating just above the splanchnic vessels ³.

Initiating the IABP