Intraaortic Balloon Pump (IABP)

Indications and Contraindications:

Indications for intraaortic balloon pumping include cardiogenic shock or heart failure.  Although the incidence of complications has decreased significantly as experience with the device has increased, IABP therapy still holds a risk for complications. Because today’s patient population is elderly (68 - 80 years), and may suffer from severe peripheral vascular disease, hypertension or diabetes, the most common complication is loss of blood flow to a limb. Therefore the patient must be continuously observed for any compromise to blood flow during IABP therapy. If signs of ischemia appear, and the balloon is not removed, it could be considered deviation from the standard of care.

Examples of possible medical negligence:

• In light of possible compromise of blood flow to a limb, strict charting by the ICU staff needs to be done documenting the patient pulses and condition of his/her skin.  If this is not documented and the patient progresses to limb ischemia it could be considered medical negligence.
• After the IABP is removed pressure needs to be applied over the artery in order to prevent a hematoma or hemorrhage.  If this is not done properly the patient could die from hypovolemic shock.  In a busy ICU an enlarging hematoma can go unnoticed for hours.