Q What are the nursing considerations for patients with axillary insertion of an intra-aortic balloon pump?

A Brandi Holcomb, MSN, APRN, AGACNP-BC, CCRN, replies:

The intra-aortic balloon pump (IABP) is a mechanical hemodynamic support device that uses counterpulsation to provide temporary circulatory assistance. An IABP is used to manage cardiogenic shock, refractory unstable angina, acute myocardial infarction, and refractory or intractable ventricular tachycardia. The device may also be used to support patients before and after cardiac surgery and to serve as a bridge to advanced therapies such as a left ventricular assist device or transplant. Additional indications include acute mitral valve regurgitation due to papillary rupture, ventricular septal rupture, as an adjunct to other ventricular assist devices, and failed percutaneous coronary intervention. An IABP should be avoided in patients with aortic dissection, significant aortic valve insufficiency, or thoracic aneurysms.

Counterpulsation is the fundamental principle underlying the IABP. Inflating...

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