Plaque abrasion and intra-aortic balloon leak.

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.