Iabp wave forms

adjusting to the timing according to the IAPB wave forms

1. Diastolic augmentation Unassisted systolic pressure Assisted systolic pressure Dicrotic Notch Unassisted diastolic pressure Assisted diastolic pressure Augmented wave form

2. Without augmentation With 1:2 augmentation

3. Diastolic Augmentation Dicrotic Notch Early inflation will increase afterload as the heart must eject blood against an inflated balloon. This inturn will result in increased myocardial wall stress and Left ventricular end diastolic pressure thereby increasing left ventricular work, reducing cardiac output. EARLY INFLATION

4. Diastolic augmentation Unassisted systolic pressure Delayed inflation of the balloon after aortic valve closure results in inadequate diastolic Augmentation. There is blunting or complete lack of diastolic augmentation waveform. Associated with this is a lack of end-diastolic pressure decrease ( afterload reduction) and no increase in diastolic perfusion pressure. There is a prolonged dip or U wave then a blunted or decreased diastolic augmentation Late Inflation

5. Early Deflation Assisted and unassisted Systolic pressure Diastolic augmentation Tracing reveals a normal diastolic augmentation but then a long drawn out U-shaped wave prior to the assisted systolic waveform . There is inadequate preload reduction and therefore no change in assisted and unassisted systolic pressure.

6. Late Deflation Diastolic augmentation Assisted systolic pressure Unassisted systolic pressure Assisted end - diastolic pressure Unassisted end-diastolic pressure Late deflation of IABP causes a dramatic increase in afterload as systole begins with higher intra-aortic pressure. This causes late opening of the aortic valve and severely reduces the cardiac output. The pressure wave form reveals an assisted end-diastolic pressure that is higher than the unassisted end-diastolic pressure and a drastically reduced assisted systolic pressure.