Assessment of limb perfusion by measurement of toe temperatures with a skin probe in patients with intraaortic balloon pumps

Assessment of peripheral perfusion is one of the most important aspects of care associated with nursing patients receiving intraaortic balloon pump (IABP) therapy. The validity of traditional methods of assessing peripheral perfusion based on colour, warmth, circulatory return, and quality of pedal pulses has\u27 been questioned because of their subjective nature. Consequently, there is a need to identify a reliable quantitative method of monitoring peripheral perfusion in patients with IABPs. Measurement of toe temperatures by use of a skin probe has long been established as a reliable quantitative indicator of the state of lower limb perfusion in critically ill patients other than those with IABPs. To date the use of a skin probe to measure toe temperatures in patients with IABPs has not been described in the literature. This prospective study used a descriptive and correlational design to describe characteristic toe temperatures in bilateral limbs of patients receiving IABP support and to examine the relationship between toe temperatures in the presence and absence of the intraaortic balloon catheter (IABC) and in the presence and absence of ischemic changes in the lower limbs. The relationship between toe temperatures and nurses\u27 conventional assessments of peripheral perfusion was also examined

Mechanical Circulatory Support Devices

Heart failure (HF) is a global public health concern that has the potential to reach epidemic proportions. The gold standard for treating end-stage HF remains heart transplantation. Unfortunately, given the scarcity of available organs, alternative means for providing cardiac support are required. Mechanical circulatory support devices (MCSDs) have the potential to treat many patients with end-stage HF. They replace some of the mechanical functions of the failing heart to improve cardiac output and organ perfusion. These include the intra-aortic balloon pump, extracorporeal membrane oxygenation, ventricular assist devices, and the total artificial heart. In this chapter, we will discuss a brief history of MCSD, available devices, indications, patient selection, surgical procedures, postoperative management, complications, and outcomes

Primary Angioplasty

Medicine; Cardiolog

Special Topics in Cardiac Surgery

This book considers mainly the current perioperative care, as well as progresses in new cardiac surgery technologies. Perioperative strategies and new technologies in the field of cardiac surgery will continue to contribute to improvements in postoperative outcomes and enable the cardiac surgical society to optimize surgical procedures. This book should prove to be a useful reference for trainees, senior surgeons and nurses in cardiac surgery, as well as anesthesiologists, perfusionists, and all the related health care workers who are involved in taking care of patients with heart disease which require surgical therapy. I hope these internationally cumulative and diligent efforts will provide patients undergoing cardiac surgery with meticulous perioperative care methods

Cardiogenic Shock

Cardiogenic shock (CS) is an end-organ hypoperfusion associated with heart failure. Any reason impairing acute left ventricular (LV) or right ventricular (RV) function may cause CS. The only way to avoid CS is to provide early reperfusion in myocardial infarction (MI) patients. CS is characterized by permanent or transient rearrangement of the entire circulatory system. According to the current IABP-SHOCK II trial, 74% of the patients with CSMI are treated with norepinephrine, 53% of them with dobutamine, 26% of them with epinephrine, 4% of them with levosimendan, and 4% of them with dopamine. Percutaneous circulatory support devices such as intra-aortic balloon pump (IABP), LV assist device (LVAD), or extracorporeal life support (ECLS) create treatment options for selected patients such as CS, cardiopulmonary resuscitation, or high-risk pPCI and CABG. Extracorporeal Life Support Organization (ELSO, 2017) evaluated that the use of ECLS/VA-ECMO should be considered when the mortality risk exceeds 50% despite optimal conventional treatment in case of acute severe heart or pulmonary failure, whereas it should be assessed as a primary indication when it exceeds 80%. Early and effective revascularization is the best treatment option for CS. Thus, the organizations on the national and global basis will play the most effective role for the short- and long-term survival of patients