Q:

A 59-year-old male has undergone successful CABG with 4 grafts constructed but remains in low cardiac output (< 2L/min/m2) postoperatively. The following is/are true:

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A 59-year-old male has undergone successful CABG with 4 grafts constructed but remains in low cardiac output (< 2L/min/m2) postoperatively. The following is/are true:


  1. An inotropic drug should be used initially to increase cardiac output
  2. If low cardiac output persists despite optimal physiological and pharmacological support, a balloon pump (IABP) should be inserted
  3. Decreased cardiac filling pressures suggest the possibility of cardiac tamponade
  4. When IABP is used, the balloon is inflated during diastole

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b. If low cardiac output persists despite optimal physiological and pharmacological support, a balloon pump (IABP) should be inserted

d. When IABP is used, the balloon is inflated during diastole

Initial efforts to improve cardiac output should include correction of poor oxygenation or acidosis and optimization of rhythm, preload and afterload before an inotropic agent is used. If low cardiac output persists despite physiological and pharmacological support, an IABP should be inserted. It improves coronary artery perfusion by counterpulsation during diastole. Cardiac tamponade is heralded by increased cardiac filling pressures, narrowed pulse pressure and pulsus paradoxus.

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