Tuesday, March 22, 2011

Scenario: 48 year old male patient is brought from OR to ICU after Coronary bypass (CABG). There was no peri-operative complication and whole procedure went smooth. IABP (Inta Aortic Baloon Pump) was inserted during surgery. On arrival perfusionist informed you that augmentation is not good. Per anesthesia report augmentation was good during the case?


Answer: In the OR the patient may be positioned with legs flexed for vein harvest. But when the legs are returned to neutral the IABP may well be pulled distally. It does not hurt to recheck the position of the IABP with TEE prior to transport to the ICU - or reposition with CXR in ICU.