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Doan V, Chaney M. "Widowmaker," Still Deserve Its Name? J Cardiothorac Vasc Anesth 2024; 38:591-594. [PMID: 38148265 DOI: 10.1053/j.jvca.2023.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Vivian Doan
- Department of Anesthesiology and Critical Care, University of Chicago, Chicago, IL.
| | - Mark Chaney
- Department of Anesthesiology and Critical Care, University of Chicago, Chicago, IL
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Erroneous Pressure Reading from an Unpowered Intra-aortic Balloon Pump: Case Report. ASAIO J 2022; 68:e211-e214. [PMID: 35593752 DOI: 10.1097/mat.0000000000001695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Intra-aortic balloon pump (IABP) technology is an established treatment modality for patients with acute cardiac failure. Advances in IABP technology have simplified use and reliability such that electromechanical malfunctions are relatively rare. We present a case of an unanticipated pressure output signal from a powered off Cardiosave IABP console resulting in an erroneous mean arterial blood pressure waveform being displayed during cardiopulmonary bypass. The patient suffered no ill effects and made a full recovery. As a result of this incident, our policies have been revised to ensure that all patients with an IABP brought to the operating room for surgery have at least two arterial lines, one of which is not off the IABP, to prevent future occurrences.
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Cormican DS, Madden C, Rodrigue MF. Mechanical circulatory support: complications, outcomes, and future directions. Int Anesthesiol Clin 2022; 60:72-80. [PMID: 35960687 DOI: 10.1097/aia.0000000000000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Daniel S Cormican
- Cardiothoracic & Transplant Anesthesiology and Surgical Critical Care, Anesthesiology Institute, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Claire Madden
- Surgical Critical Care, Surgery Institute, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Marc F Rodrigue
- Cardiothoracic Anesthesiology, Anesthesiology Institute, Allegheny Health Network, Pittsburgh, Pennsylvania
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Rossini R, Valente S, Colivicchi F, Baldi C, Caldarola P, Chiappetta D, Cipriani M, Ferlini M, Gasparetto N, Gilardi R, Giubilato S, Imazio M, Marini M, Roncon L, Scotto di Uccio F, Somaschini A, Sorini Dini C, Trambaiolo P, Usmiani T, Gulizia MM, Gabrielli D. ANMCO POSITION PAPER: Role of intra-aortic balloon pump in patients with acute advanced heart failure and cardiogenic shock. Eur Heart J Suppl 2021; 23:C204-C220. [PMID: 34456647 PMCID: PMC8387780 DOI: 10.1093/eurheartj/suab074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The treatment of patients with advanced acute heart failure is still challenging. Intra-aortic balloon pump (IABP) has widely been used in the management of patients with cardiogenic shock. However, according to international guidelines, its routinary use in patients with cardiogenic shock is not recommended. This recommendation is derived from the results of the IABP-SHOCK II trial, which demonstrated that IABP does not reduce all-cause mortality in patients with acute myocardial infarction and cardiogenic shock. The present position paper, released by the Italian Association of Hospital Cardiologists, reviews the available data derived from clinical studies. It also provides practical recommendations for the optimal use of IABP in the treatment of cardiogenic shock and advanced acute heart failure.
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Affiliation(s)
- Roberta Rossini
- Division of Cardiology, Emergency Department and Critical Areas, Azienda Ospedaliera Santa Croce e Carle, Via Michele Coppino 26, 12100 Cuneo, Italy
| | - Serafina Valente
- Clinical-Surgical-CCU Cardiology Department, Azienda Ospedaliero-Universitaria Senese Ospedale Santa Maria alle Scotte, Siena, Italy
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Department, Presidio Ospedaliero San Filippo Neri-, ASL Roma 1, Roma, Italy
| | - Cesare Baldi
- Interventional Cardiology-Cath Lab Department, Azienda Ospedaliera Universitaria San Giovanni di Dio-Ruggi d'Aragona, Salerno, Italy
| | | | | | - Manlio Cipriani
- Cardiology 2-Heart Failure and Transplants, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Marco Ferlini
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Rossella Gilardi
- Department of Cardiac Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Simona Giubilato
- Cardiology-CCU -Cath Lab Department, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Massimo Imazio
- Division of Cardiology, Presidio Molinette, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Marco Marini
- Cardiology-CCU -Cath Lab Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - Loris Roncon
- U.O.C. Cardiologia, Ospedale Santa Maria della Misericordia, Rovigo, Italy
| | | | - Alberto Somaschini
- Department of Cardiology and Cardiac Intensive Care Unit, Ospedale San Paolo, Savona, Italy
| | | | - Paolo Trambaiolo
- Cardiology-ICU Department, Presidio Ospedaliero Sandro Pertini, Roma, Italy
| | - Tullio Usmiani
- Division of Cardiology, Presidio Molinette, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Michele Massimo Gulizia
- Cardiology Department, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania, Italy.,Fondazione per il Tuo cuore-Heart Care Foundation, Firenze, Italy
| | - Domenico Gabrielli
- Cardiology Unit, Cardiotoracovascular Department, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
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Daubenspeck D, González LS, Gerlach RM, Chaney MA. Unique Complications Associated With the Subclavian Intra-Aortic Balloon Pump. J Cardiothorac Vasc Anesth 2020; 35:2212-2222. [PMID: 33485757 DOI: 10.1053/j.jvca.2020.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 12/25/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Danisa Daubenspeck
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL
| | - Laura S González
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI
| | - Rebecca M Gerlach
- Department of Anesthesiology and Critical Care, Preoperative Anesthesia Clinic, University of New Mexico, Albuquerque, NM; Preoperative Anesthesia Clinic, University of New Mexico, Albuquerque, NM
| | - Mark A Chaney
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL.
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Del Carmen GA, Axtell A, Chang D, Melnitchouk S, Sundt TM, Fiedler AG. Intra-aortic balloon pump placement in coronary artery bypass grafting patients by day of admission. J Cardiothorac Surg 2020; 15:219. [PMID: 32795363 PMCID: PMC7427862 DOI: 10.1186/s13019-020-01259-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 07/30/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Intra-Aortic Balloon Pumps (IABPs) can be utilized to provide hemodynamic support in high risk patients awaiting coronary artery bypass grafting (CABG). There are many indications for IABP and institutional practice patterns regarding the placement of IABPs is variable. As a result, the preoperative placement of an IABP in a patient awaiting CABG is not standardized and may vary according to non-clinical factors. We hypothesize that the rate of IABP placement varies by day of the week. METHODS A retrospective cohort analysis of the Office of Statewide Health Planning and Development database from 2006 to 2010 was performed. All patients admitted for CABG were included. Patients who died within 24 h of admission and those who had absolute contraindications to IABP placement were excluded. The primary outcome was preoperative IABP placement versus non-placement. A multivariable logistic regression analysis to identify predictors of IABP placement was performed, adjusting for patient demographics, clinical factors, and system variables. RESULTS A total of 46,347 patients underwent CABG, of which 7695 (16.60%) had an IABP placed preoperatively. On unadjusted analysis, IABP rates were significantly higher on weekends versus weekdays (20.83% vs. 15.70%, p < 0.001). On adjusted analysis, patients awaiting CABG were 1.30 times more likely to have an IABP placed on weekends than on weekdays (OR: 1.30, 95% CI 1.20-1.40, p < 0.001). CONCLUSION The odds of preoperative IABP placement prior to CABG is significantly increased on weekends compared to weekdays, even when controlling for clinical factors. Further exploration of this phenomenon and its associations are warranted.
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Affiliation(s)
- Gabriel A Del Carmen
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrea Axtell
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David Chang
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Serguei Melnitchouk
- Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Thoralf M Sundt
- Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Amy G Fiedler
- Division of Cardiothoracic Surgery, University of Wisconsin, H4/320 CSC, 600 Highland Ave, Madison, WI, 53792, USA.
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Intra-Aortic Balloon Pump for Patients with Cardiac Conditions: An Update on Available Techniques and Clinical Applications. REPORTS 2019. [DOI: 10.3390/reports2030019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In this paper, we present a review of the intra-aortic balloon pump, as well as the usage of it in the medical field today. An intra-aortic balloon pump (IABP) is a biomedical device that can assist the heart during unstable angina or after a heart attack. This pump is typically used in patients who suffer from ischemia of the heart tissue, due to an unbalanced level of myocardial oxygen supply or demand. Through counterpulsation, which is a technique to synchronize the external pumping of blood with the heart’s cycle, the device can balance the supply and demand of blood that is necessary for the heart to pump properly. The IABP is comprised of the following four components: a polyurethane balloon, a polyethylene or fiber-optic catheter, a transducer, and the intra-aortic balloon pump console. In the past, researchers have used other materials that have low biocompatibility and can cause complications within the body. This analysis will explain the complications and state changes that occurred due to them. Limitations of past designs and advantages of current designs will be acknowledged, for they can be used by researchers to enhance designs for the future. Consequently, the analysis of this device may lead to improved designs and treatment in the future for patients with cardiac conditions.
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