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

Summary

Interpretation of the arterial pressure waveform is a much more complicated task in the IAB-pumped patient. Clinicians must exercise meticulous interpretive skills when analyzing and quantifying pressures in this patient population. Confusion and inconsistencies can easily occur, particularly if the nurse relies on bedside digital analysis of blood pressure. Conventional monitor instrumentation is not designed to distinguish IABP-pumped pressure reference points of diastolic augmentation produced by balloon inflation or balloon-assisted aortic end-diastolic pressure. Clinicians must also recognize that multiple variables can impact the magnitude of diastolic augmentation. These parameters should not be used to determine efficacy or measure IAB pumping outcomes. Rather, parameters that measure perfusion and flow, such as oxygen saturation and oxygen delivery, provide a much more accurate picture as to whether IAB pumping is improving myocardial performance. Nurses must collaborate and develop procedures to assure continuity and consistency when measuring and interpreting blood pressure in the IAB-pumped patient.

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