Which of the following is an indication for IABP (intra-aortic balloon pump)?

AIIMS M.Sc. Nsg Entrance exam-2026

Medical & Surgical Nursing

Easy

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

Cardiogenic shock is a state of low cardiac output resulting from myocardial pump failure, which is the exact problem an IABP is designed to address.
The IABP works via counter-pulsation, inflating during diastole to increase coronary artery perfusion and deflating during systole to decrease afterload.
This mechanism directly improves the myocardial oxygen supply-demand ratio, which is critically impaired in cardiogenic shock.
While recent large trials have questioned its routine use for mortality benefit in all cardiogenic shock patients, it remains a therapeutic option for hemodynamic support in this condition.

Option A: Septic shock is a distributive shock caused by infection and widespread vasodilation. An IABP does not address this pathophysiology and is generally contraindicated due to the risk of bacteremia and seeding the device with infection.
Option C: Pericarditis is an inflammatory condition of the pericardium. It is not a problem of myocardial contractility unless it leads to cardiac tamponade, which is treated by pericardiocentesis, not IABP.
Option D: Pulmonary embolism is a form of obstructive shock. It causes acute right ventricular failure due to a blockage in the pulmonary artery. The treatment is focused on removing the clot (thrombolysis or thrombectomy), not supporting the left ventricle with an IABP.

Visual 1: Diagram: Placement of the IABP in the descending aorta, showing the balloon's position distal to the left subclavian artery and proximal to the renal arteries.
Visual 2: Flowchart: The principle of counter-pulsation, illustrating the cardiac cycle with balloon inflation during diastole (improving coronary flow) and deflation during systole (reducing afterload).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Indications for Intra-Aortic Balloon Pump (IABP) Therapy as background academic context rather than a clinical decision trigger.
Nurses caring for patients with an IABP must perform frequent neurovascular checks of the cannulated limb (usually the leg) to monitor for signs of ischemia, such as pain, pallor, pulselessness, paresthesia, and paralysis.
Precise timing of the IABP with the cardiac cycle is crucial for its effectiveness and to prevent harm. The nurse must monitor the arterial waveform and ensure it shows proper augmentation.
Urine output must be monitored closely, as downward migration of the balloon can occlude the renal arteries, leading to acute kidney injury.

How to Approach the Question

Identify the core of the question: It asks for a primary indication for using an IABP.
Recall the function of an IABP: It is a mechanical device that assists the heart's pumping function.
This immediately points to a condition characterized by 'pump failure'.
Evaluate the options based on their underlying pathophysiology:
Cardiogenic shock: This is the classic definition of pump failure.
Septic shock: This is a distributive shock (a 'pipe' or vasodilation problem).

Concept Tested & Keywords

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