An intra-aortic balloon pump can be removed when all of the following are present.
Reduced demand:
(1) counterpulsation assist ratio 1:3 or 1:4
(2) no or minimal inotropic drug support
Adequate physiologic measures:
(1) cardiac output index > 2.0 L per minute per meter square
(2) systolic blood pressure > 100 mm Hg
(3) urine output > 30 mL per hour
(4) left atrial or pulmonary wedge pressure < 15 mm Hg
Absence of cardiac ischemic changes:
(1) no angina
(2) no ischemic changes on the ECG
(3) no new ventricular arrhythmias
where:
• The counterpulsation assist ratio reflects how often the pump augments left ventricular contraction. A ratio of 1:X indicates one IABP assist for each X beats of the heart.
