ผลของโปรแกรมป้องกันภาวะแทรกซ้อนที่พบบ่อย ในผู้ป่วยที่ได้รับการรักษาด้วยเครื่องพยุงการทำงานของหัวใจ

Banthita Chaiyotha; Maliwan Silarat

Authors

Banthita Chaiyotha Faculty of Nursing, Khon Kaen University
Maliwan Silarat Faculty of Nursing, Khon Kaen University

Keywords:

intra-aortic balloon pump, complications prevention program, hematoma, acute limb ischemia, bleeding

Abstract

This quasi-experimental study with a two-group posttest design aimed to study the effects of common complications prevention program among patients treated with intraaortic balloon pump. The study sample comprised 30 patients treated with intra-aortic balloon pump, who were purposively assigned to a control group (n = 15) and the experimental group (n = 15). The experimental group received 72 hours of nursing care as per the program. Data collection was conducted from May 2024 to March 2025. Research instruments included: 1) the common complications prevention program, 2) a complications risk assessment tools, and 3) a complications assessment form. These instruments have content Validity Index (CVI) of 0.97, 0.90, and 1.0, respectively. Data were analyzed using descriptive statistics and inferential statistics, including Cox proportional hazards regression, chi-square test, Fisher's exact test, independent t-test and two-way repeated measures ANOVA.

The results of the study revealed that: the experimental group who received the program had a significantly lower incidence of overall complications than the control group (p = .002). Specifically, the experimental group experienced a significantly lower incidence of bleeding compared to the control group (p = .025). However, there were no statistically significant differences between the two groups in the incidence of hematoma and acute limb ischemia (p > .05).

In conclusion, the developed program for preventing common complications in patients treated with an intra-aortic balloon pump was effective in reducing bleeding complications in patients treated with an intra-aortic balloon pump. Therefore, it is recommended that nurses apply this program in their care to prevent complications and enhance positive clinical outcomes for this patient population

References

World Health Organization. World health statistics 2024: monitoring health for the ±SDGs, Sustainable Development Goals. Geneva: World Health Organization; 2024. 96 p.

Strategy and Planning Division, Ministry of Public Health. Public health statistics A.D. 2023 [Internet]. Nonthaburi: Ministry of Public Health; 2023 [cited 2025 Feb 20]. Available from: https://spd.moph.go.th/wp-content/uploads/2025/02/รายงานสถิติสาธารณสุข-ประจำปี2566_V2.pdf (in Thai)

González LS, Grady M. Intra-aortic balloon pump counterpulsation: technical function, management, and clinical indications. Int Anesthesiol Clin 2022;60(4):16-23.

Thiele H, de Waha-Thiele S, Freund A, Zeymer U, Desch S, Fitzgerald S. Management of cardiogenic shock. EuroIntervention 2021;17(6):451-65.

Motia N, Marko V, Karlsen MW. Complications associated with intra-aortic balloon pump treatment in critically ill patients: a systematic review. Nurs Crit Care 2024;29(6):1768-80.

Manshadi ±SD, Eisenberg N, Montbriand J, Luk A, Roche-Nagle G. Vascular complications with intra-aortic balloon pump (IABP): experience from a large Canadian metropolitan centre. CJC Open 2022;4(11):989-93. doi:10.1016/j.cjco.2022.08.008.

Azazy A, Farid WA, Ibrahim WA, El Shafey WEH. Survival benefit of IABP in pre-versus post-primary percutaneous coronary intervention in patients with cardiogenic shock. Egypt Heart J 2024;76(1):99.

Tong W, Wang JM, Li JY, Li PY, Chen YD, Zhang ZB, et al. Incidence, predictors, and prognosis of thrombocytopenia among patients undergoing intra-aortic balloon pumping in the intensive care unit: a propensity score analysis. J Geriatr Cardiol. 2021;18(2):123-34.

Gillespie LE, Lane BH, Shaw CR, Gorder K, Grisoli A, Lavallee M, et al. The intra-aortic balloon pump: a focused review of physiology, transport logistics, mechanics, and complications. J Soc Cardiovasc Angiogr Interv 2024;3(5):101337.

Queen Sirikit Heart Center of the Northeast. Cardiac intensive care unit database [unpublished data]. Khon Kaen: Queen Sirikit Heart Center of the Northeast; 2023. (in Thai)

Lavin W. Application of the CRUSADE bleeding risk score to predict groin hematoma after cardiac catheter removal. Mahidol R2R e-J 2020;7(2):44-53. (in Thai)

Chichareon P, Chamnarnphol N, Chandavimol M, Suwannasom P, Roongsangmanoon W, Limpijankit T, et al. Updated CRUSADE score to predict in-hospital bleeding: external validation in the Thai percutaneous coronary intervention registry. Catheter Cardiovasc Interv 2024;103(2):268-75.

Gary T, Belaj K, Hafner F, Eller P, Rief P, Hackl G, et al. Graz Critical Limb Ischemia Score: a risk score for critical limb ischemia in peripheral arterial occlusive disease. Medicine (Baltimore) 2015;94(27):e1054.

Taebtam S, Wonggom P, Tanmit P. Effects of evidence-based nursing care for promoting peripheral tissue perfusion among critically ill patients with peripheral artery disease: a single-blinded randomized controlled trial. Nurs Sci J Thail 2024;42(4):1-13. (in Thai)

Chiaranai C, Peungngean S, Prommart S, Doommai N. Nursing care of a patient receiving intra-aortic balloon pump for treatment: a case study. J Health Sci BCNSP 2022;6(1):1-15. (in Thai)

Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, et al. Editor’s choice-European Society for Vascular Surgery (ESVS) 2024 clinical practice guidelines on the management of asymptomatic lower limb peripheral arterial disease and intermittent claudication. Eur J Vasc Endovasc Surg 2024;67(1):9-96.

Suksumek T, Orrapin S. Diagnostic and management on acute aortic occlusion. Journal of the Association of General Surgeons of Thailand under the Royal Patronage of HM the King 2021;6(3):148-69. (in Thai)

Tocharoenchok T, Lerdpunnapongse P. The use of intra-aortic balloon pump: IABP. Siriraj Med Bull 2021;14(1):19-29. (in Thai)

Rhodes NG, Johnson TF, Boyum JH, Khandelwal A, Howell BD, Froemming AT, et al. Radiology of intra-aortic balloon pump catheters. Radiol Cardiothorac Imaging 2022;4(2):e210120. doi:10.1148/ryct.210120.

Rasaria S, Sawant S. The role of nurses in patients with intra-aortic balloon pump: involvement, understanding, and management of the patient’s comfort. Innovational: Journal of Nursing and Healthcare 2019;5(2):16-9.

Asber SR, Shanahan KP, Lussier L, DiDomenico D, Davis M, Eaton J, et al. Nursing management of patients requiring acute mechanical circulatory support devices. Crit Care Nurse 2020;40(1):e1-11.

Guan X, Chen M, Li Y, Zhang J, Xu L, Sun H, et al. Comparison of safety between different kinds of heparins in patients receiving intra-aortic balloon counterpulsation. Thorac Cardiovasc Surg 2021;69(6):511-7.

Niknam SH, Farsi Z, Butler S, Pishgooie AH. Comparison of the effectiveness of position change for patients with pain and vascular complications after transfemoral coronary angiography: a randomized clinical trial. BMC Cardiovasc Disord. 2021;21(1):114.

Johnson RA, Kast FE, Rosenzweig JE. Systems theory and management. Manage Sci 1964;10(2):367-84.

Hammood AB, Mahmood FM. Effect of ice bag with direct pressure in the prevention of local vascular complications after femoral sheath removal post-cardiac catheterization: a randomized clinical trial. HIV Nurs 2022;22(2):2308-16.

Lu L, Zhang S, Zhang Y, Zhao X. Discrepancy between two invasive blood pressure measurements in patients receiving intra-aortic balloon pump therapy. BMC Cardiovasc Disord. 2023;23(1):445. doi:10.1186/s12872-023-03479-2.

Pattanajak C, Wongvipaporn C, Kankong C, Kothsombat P, Arit T. Effectiveness of leg lock to reduce hematoma in patients undergoing coronary angiography and percutaneous coronary intervention. Research and Development Health System Journal 2019;12(3):821-7. (in Thai)

Normkusol J, Samanchai S. Development of an assessment and prevention of complications form for patients with intra-aortic balloon pump. Journal of Vongchavalitkul Universit 2020;33(2):1-11. (in Thai)