Bedside Cardiac ICU
Recent publications by cardiovascular societies related to COVID-19 pandemic outbreak, suggest that “Given the infectious risk of transporting patients from wards to the catheterization lab, some procedures routinely done in the catheterization laboratory should be considered for bedside performance. Examples include pulmonary artery catheter placement, pericardiocentesis, and intra-aortic balloon pump“.
The Bedside Cardiac ICU module on the Simbionix ANGIO Mentor is designed to provide practice for interventions that are being performed at the bedside of suspected/confirmed COVID-19 patient with no fluoroscopic guidance instead of the standard practice at the cath lab. The module includes simulation cases of Right Heart Catheterization (RHC) and Intra-Aortic Balloon Pump (IABP) interventions.
The module is designed for Interventional Cardiologists, Pulmonologists and Anesthesiologists.
Right Heart Catheterization (RHC)
- RHC is a diagnostic procedure used in patients with either suspicion of heart failure, shock, pulmonary hypertension and more. I used to be a common practice a few decades ago but younger physicians are not experienced with it.
- RHC is performed by a wedge pressure balloon catheter, also known as the Swan-Ganz catheter, used to record pressures and their waveforms and measure cardiac output and vascular resistance.
- RHC measurements are beneficial in COVID-19 patients to monitor and diagnose cardiovascular complications of the virus.
Intra-Aortic Balloon Pump (IABP)
- IABP is a short-term treatment for cardiogenic shock.
- There are indications that cardiogenic shock in COVID-19 patients can be treated with IABP, also because it requires the least maintenance from medical support staff.
- Inserting IABP without fluoro guidance to the correct position is not an easy task. Before activating the pump, the location is usually verified using a mobile X-ray machine. This step is also simulated in the module.
- Ability to practice with no fluoroscopy – the cases emphasize complementary measures such as hemodynamic monitoring and physical measurements.
- Self-Guided cases through the clinical step-by-step with written and illustrated explanations.
- Rich didactic library of videos.
- Calculating Pulmonary Vascular Resistance (PVR) – during the RHC cases, the trainee can calculate the patient’s PVR using the hemodynamic measurements acquired by the balloon catheter.
- Setting the IABP parameters – the trainee can experience activating the pump in different frequencies and timing and examine its clinical outcome.
The module was developed in collaboration with the following KOLs:
Prof. Israel Barabash
Director, Cath Lab Services
Leviev Heart Institute
Sheba Medical Center
Mladen I. Vidovich, MD, FACC, FSCAI
Professor of Medicine, University of Illinois
Chief, Section of Cardiology, Jesse Brown VA Medical Center
Chair, Federal Section, American College of Cardiology
Associate Editor, JACC Case Reports