Use of a percutaneous temporary circulatory support device as a bridge to decision during acute decompensation of advanced heart failure

Hall, Shelley; Uriel, Nir; Carey, Sandra; Edens, Madison; Gong, Geoffrey; Esposito, Michele; O’Kelly, Ryan; Annamalai, Shiva; Aghili, Nima; Adatya, Sirtaz; Kapur, Navin K.

doi:10.1016/j.healun.2017.09.020

Cited by 76 publications

(52 citation statements)

References 16 publications

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“…favored over the 2.5 or CP devices for patients with advanced heart failure requiring prolonged support. 21 Axillary insertions allow for the option of mobilizing the patient, which can be critical for surgical optimization if the patient needs a bridge to a durable VAD or to transplant. 11,22 The Impella LD can be surgically inserted directly into the aorta during open heart surgery, often when a patient is unable to come off of bypass because of LV failure.…”

Section: Mechanicsmentioning

confidence: 99%

“…of an 80% mortality risk, a ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (Fio 2 ) of less than 80, and/or a Murray score of 3 to 4 from the previously mentioned lung failure. 21 Other considerations when evaluating patients for VV ECMO are length of time receiving mechanical ventilator support, age, comorbidities and preexisting conditions, and likelihood of bridge to lung transplant. 24…”

Section: Venovenous Indicationsmentioning

confidence: 99%

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Nursing Management of Patients Requiring Acute Mechanical Circulatory Support Devices

Asber

Shanahan

Lussier

et al. 2020

Critical Care Nurse

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Topic The growing use of acute mechanical circulatory support devices to provide hemodynamic support that has accompanied the increasing prevalence of heart failure and cardiogenic shock, despite significant improvement in the treatment of acute myocardial infarction. Clinical Relevance The critical care nurse plays a crucial role in managing patients receiving acute mechanical circulatory support devices and monitoring for potential complications. Purpose To review the anatomical placement and mechanics of each type of device so that nurses can anticipate patients’ hemodynamic responses and avoid complications whenever possible, thereby improving patients’ clinical outcomes. Content Covered Nursing considerations regarding the intra-aortic balloon pump, the TandemHeart, the Impella, and extracorporeal membrane oxygenation.

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Section: Mechanicsmentioning

confidence: 99%

Section: Venovenous Indicationsmentioning

confidence: 99%

Nursing Management of Patients Requiring Acute Mechanical Circulatory Support Devices

Asber

Shanahan

Lussier

et al. 2020

Critical Care Nurse

Self Cite

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show abstract

“…1). After exclusion, 12 articles (including 1 via cross-reference) remained for qualitative and quantitative synthesis and meta-analysis [5,[12][13][14][15][16][17][18][19][20][21][22]. Nine of the 12 studies were observational.…”

Section: Study Characteristicsmentioning

confidence: 99%

Haemodynamic efficacy of microaxial left ventricular assist device in cardiogenic shock: a systematic review and meta-analysis

et al. 2019

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The Impella percutaneous mechanical circulatory support device is designed to augment cardiac output and reduce left ventricular wall stress and aims to improve survival in cases of cardiogenic shock. In this meta-analysis we investigated the haemodynamic effects of the Impella device in a clinical setting. We systematically searched all articles in PubMed/ Medline and Embase up to July 2019. The primary outcomes were cardiac power (CP) and cardiac power index (CPI). Survival rates and other haemodynamic data were included as secondary outcomes. For the critical appraisal, we used a modified version of the U.S. Department of Health and Human Services quality assessment form. The systematic review included 12 studies with a total of 596 patients. In 258 patients the CP and/or CPI could be extracted. Our meta-anal-D.I.M. van Dort and K.R.A.H. Peij contributed equally to this manuscript. ysis showed an increase of 0.39 W [95% confidence interval (CI): 0.24, 0.54], (p = 0.01) and 0.22 W/m 2 (95% CI: 0.18, 0.26), (p < 0.01) for the CP and CPI, respectively. The overall survival rate was 56% (95% CI: 0.50, 0.62), (p = 0.09). The quality of the studies was moderate, mostly due to the presence of confounders. Our study suggests that in patients with cardiogenic shock, Impella support seems effective in augmenting CP(I). This study merely investigates the haemodynamic effectiveness of the Impella device and does not reflect the complete clinical impact for the patient. Review Article ConclusionOur meta-analysis shows that short-term MCS with the Impella device is effective in increasing CP and CPI. Despite successfully increased CP with Impella support, the mortality seems to be in line with the survival rate without Impella use.

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“…There have been reports of successful use of Impella 5.0 for hemodynamic support in cardiogenic shock in order to prolong the time needed to make a decision for long-term management. [14][15][16] The cost associated with this technology is considerable ($35,000-$50,000 per device console), and the disposable components range from $1000 to $32,000. 17 The index admission cost for patients being treated with a percutaneous ventricular assist device was around $91,000 with an average length of stay of 13 days.…”

Section: Types Of Temporary Mechanical Cardiac Supportmentioning

confidence: 99%

Percutaneous temporary circulatory support devices and their use as a bridge to decision during acute decompensation of advanced heart failure

Afzal

Hall

2018

Baylor University Medical Center Proceedings

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Temporary mechanical cardiac support (TMCS) devices intend to restore systemic perfusion and prevent further end-organ damage in patients with refractory cardiogenic shock until the insult is addressed. TMCS has been associated with reductions in hospital costs and in-hospital mortality. We review the four primary TMCS modalities available: intra-aortic balloon pump, TandemHeart, veno-arterial extracorporeal membrane oxygenation, and Impella pump. All have their own implantation technique and hemodynamic profile, and their use may therefore be tailored to the specific patient's needs. The appropriate TMCS may thus help stabilize the patient, enabling the care team to make decisions about durable support or transplantation.

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Use of a percutaneous temporary circulatory support device as a bridge to decision during acute decompensation of advanced heart failure

Cited by 76 publications

References 16 publications

Nursing Management of Patients Requiring Acute Mechanical Circulatory Support Devices

Nursing Management of Patients Requiring Acute Mechanical Circulatory Support Devices

Haemodynamic efficacy of microaxial left ventricular assist device in cardiogenic shock: a systematic review and meta-analysis

Percutaneous temporary circulatory support devices and their use as a bridge to decision during acute decompensation of advanced heart failure

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