Generally, it is preferable to have the patient receive IECP therapy before dialysis as the increased intravascular volume increases diastolic augmentation and venous return. Conversely, the increased vascular volume could potentially reduce systolic unloading and induce pulmonary congestion.
Therefore, it is important to take into account the patient’s cardiac status. For example, a CHF patient is probably not a good candidate for pre-dialysis IECP therapy, but a patient with an EF of 40 per cent or greater might tolerate pre-dialysis treatment. A trial IECP therapy session to evaluate the patient's tolerance of the treatment will provide important information for managing the course of therapy. Whether pre- or post-dialysis, pre- and post-IECP lung auscultation, monitoring oxygen saturation and adjusting timing to maximize systolic unloading help minimize adverse responses to IECP for dialysis patients.