Current practice is an important component of evidence-based practice. This resource provides a discussion of timing practice and assessment guidelines and a detailed description of the impact of physiological and nonphysiological factors on the efficacy of intra-aortic balloon pump (IABP) therapy.

Timing assessment is the process of determining if the timing settings are correct relative to the cardiac cycle. Conventional timing dictates that all actions of the IABP occur in diastole, so inflation should occur at the dicrotic notch and deflation before the next systolic ejection. To assess timing, set the IABP at 1:2 assist to allow comparison of assisted and unassisted beats. Figure 1 shows the assessment points.

To assess inflation, draw a line (circled 1 on the figure) from visible dicrotic notch to dicrotic notch. The inflation point or V between systole and augmentation should be on or slightly above the line. If the V is too far...

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