Interpreting the Arterial Pressure Waveform in the Intra-aortic Balloon-Pumped Patient

Susan J. Quaal, PhD, APRN, CVS, CCRN, University of Utah Health Sciences Center and Department of Cardiology, VA Salt LakeHealthcare System

Prog Cardiovasc Nurs. 2001;16(3) 

In This Article

How Does Blood Pressure Differ in the Iab-Pumped Patient and Which Pressures Should Be Documented?

Figure 2 illustrates the familiar arterial pressure waveform representative of the non-IAB-pumped patient. Systole is normally the highest pressure point generated. The aortic valve opens, rapid ejection occurs, and the ventricle delivers 66%-75% of its stroke volume.[1] Thereafter, flow velocity declines until the pressure in the ventricle falls below aortic pressure and the aortic valve closes, which is marked by the "dicrotic notch," or "incisura."

Arterial pressure waveform, PSP=peak systolic pressure; DN=dicrotic notch; AVO=aortic valve opens; AEDP=aortic end-diastolic pressure.

Figure 3 depicts an arterial pressure waveform altered by IAB pumping and assisting every other beat, which is known as an assist ratio of 1:2. Reference points are expanded to five components:

  1. balloon inflation, termed "diastolic augmented pressure";

  2. balloon deflation during end-diastole producing a low pressure point termed "balloon assisted aortic end-diastolic pressure" (BAEDP);

  3. patient's aortic end-diastolic pressure (without the IAB impact), called "unassisted aortic end-diastolic pressure," (UAEDP);

  4. assisted systole, or the systolic pressure that is generated after a balloon inflation-deflation cycle; and

  5. systole without a preceding IAB-pumped beat, termed "unassisted systole."

Arterial pressure waveform; from an IAB-pumped patient with a 1:2 ratio of assist. See text for explanation of pressure reference points.

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