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Plaque abrasion and intra-aortic balloon leak
P M Cox1, M Kellett, S F Goran
1Department of Critical Care Medicine, Maine Medical Center, Portland 04102, USA.
Study Objective:
To determine and correct cause of high incidence of intra-aortic balloon leaks (ruptures).
Design:
Epidemiologic investigation of factors associated with intra-aortic balloon leak, and sequential application of corrective measures evaluated by continued concurrent data collection.
Setting:
Thirty-four-bed ICU in 598-bed tertiary care medical center.
Interventions:
Procedure changed to place smaller balloons (34 mL instead of 40 mL) in patients less than 163 cm in height.
Measurements And Results:
Demographic and clinical data on all patients showed no change after initial interventions, followed by significant drop (8 to 2%) in incidence of balloon leak when smaller, shorter balloons were placed in shorter patients.
Conclusions:
Placement of larger, longer balloons in patients increases risk of perforation of balloon by calcific plaque in the distal thoracic and abdominal aorta.