Intraaortic balloon pump (IABP) and pulse oximetry

Resuscitation 45 (2000) 63 – 64 www.elsevier.com/locate/resuscitation

Letter to the Editor Intraaortic balloon pump (IABP) and pulse oximetry Pulse oximetry offers a non-invasive method of determining whether oxygen supplementation is needed and, once delivered, whether supplementation is adequate. Despite several well-known conditions which adversely affect the accuracy of the measurement, pulse oximeters have been widely employed in intensive care units for continuous monitoring, locating an artery, during difficult in-

tubation and systolic blood pressure measurement [1]. We want to report an observation that suggests, that pulse oximetry may be helpful in another condition. A 70-year-old male patient underwent emergency percutaneous transluminal coronary angioplasty (ptCA) for acute myocardial infarction. During the procedure a stent was placed in the right coronary artery. Due to the complexity of the coronary anatomy (occluded left circumflex and narrowed left anterior descending coronary

Fig. 1. Pulse oximetry and ECG curves during IABP 1:1, 1:2, and no inflation. 0300-9572/00/$ - see front matter © 2000 Elsevier Science Ireland Ltd. All rights reserved. PII: S 0 3 0 0 - 9 5 7 2 ( 0 0 ) 0 0 1 4 4 - 1

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Letter to the Editor

artery) intraaortic balloon pump (IABP) was initiated after the procedure. As the patients clinical situation improved he was weaned after 16 h. In weaning phase pulse oximetry recordings were obtained (Fig. 1) and these are explained as follows:

Thus pulse oximetry during IABP treatment may offer additional information of the efficacy of diastolic augmentation both during 1:1 and 1:2 balloon inflations.

Upper strip (pulse oximetry and ECG cur6es during 1:1 IABP inflation) : Diastolic augmentation (high peak) after each systolic pulse wave (low peak) of the pulse oximetry curve.

References

Middle strip (pulse oximetry and ECG cur6es during 1:2 IABP inflation) : Diastolic augmentation (high peak) only after every after systolic pulse wave (low peaks) of the pulse oximetry curve. Note that the postaugmentation systolic wave appears smaller than the preaugmentation wave. Lower strip (pulse oximetry and ECG cur6es during IABP off, i.e. no inflation) : No diastolic augmentation after each systolic pulse wave of the pulse oximetry curve.

[1] Curley FJ, Smyrnios NA. Routine monitoring of critically ill patients. In: Rippe RM, Irwin RS, Alpert JS, Fink MP, editors. Intensive Care Medicine 2. Edition. Boston, Toronto, London: Little, Brown and Company, 1991:207–9.

Anton N. Laggner, Fritz Sterz, H. Domanovits Emergency Department, Vienna General Hospital, Medical Faculty, Uni6ersity of Vienna, Waehringer Guertel 18 -20, A-1090 Wien, Austria

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