What pediatric nurse needs to know about #Impella cardiac assist device
⚙️ Impella micro-axial pump
🧸 pediatric factors to determine candidacy
🔍 how to check catheter position
🔍 how to assess/change access site dressing
🩸 anticoagulation management
🔍 what to look at bedside
⚠️ associated complications
🚑 transport
🩸 #ECPELLA & BIPELLA
🌱 weaning
#FOAMcc #FOAMecmo #PedsICU #FOANed
🔓 https://bit.ly/4b5An9v
From the #EuroELSO2024 Perfusion special issue
🔓 journals.sagepub.com/toc/prfa/39/1_suppl
Long awaited RCT on routine Impella in cardiogenic shock due to myocardial infarction. Much to dissect here, but does seem to lead to a mortality benefit, though clear downsides too. #cardiology #cardiaccriticalcare #criticalcare #impella #cardiogenicshock https://www.nejm.org/doi/full/10.1056/NEJMoa2312572

A troubled #heart #pump that has now been linked to 🔸49 deaths 🔸and dozens of injuries worldwide will be allowed to remain in use,
despite the Food and Drug Administration’s decision to issue an alert about the risk that it could puncture a wall of the heart.

The tiny #Impella pumps, about the width of a candy cane, are threaded through blood vessels to take over the work of the heart in patients who are undergoing complex procedures or have life-threatening conditions.

The F.D.A. said the manufacturer of the device, #Abiomed, should have notified the agency more than two years ago, when the company first posted an update on its website about the perforation risk.

Such a notice, the F.D.A. added, would have led to a much broader official agency warning to hospitals and doctors.
The alert is the latest of concerns raised in recent years about the deadly side effects of #cardiac #devices, especially those that take over the heart’s role in circulating blood.
It is the third major F.D.A. action for an Impella device in a year.

https://www.nytimes.com/2024/03/29/health/fda-heart-pump-fatalities.html?smid=nytcore-ios-share&referringSource=articleShare

FDA Issues Alert on Heart Pump Linked to Deaths

The agency faulted the device maker for delayed notice of mounting complications, citing increasing reports of how use of the device perforated the walls of the heart.

The New York Times
Successful use of concomitant VA #ECMO & #Impella (= ECpella or ECMella) in cardiac arrest, strategy incorporating
🩸#ECPR
🖥️ TEE in ED for cannula positioning, assessment of cardiac function, guide EBF adjustments, confirm AV opening/aortic root washout/need for LV unloading)
🗜️automatic chest compressions (pre #ECLS & continued if lack of forward flow until unloading)
🫀Impella in hybrid OR if severely reduced EF, reduced/no AV opening, severe LV dilation, evidence stasis
🔓 https://bit.ly/3SeqJsV
ECPELLA: Beyond a Left Ventricular Venting Strategy When to ... : ASAIO Journal

n Impella device (colloquially referred to as ECPELLA or ECMELLA) for patients resuscitated with VA ECMO after a short period of cardiac arrest. Despite the described benefit of LV unloading with VA ECMO for cardiopulmonary resuscitation, it remains unclear as to what criteria should be used and what other diagnostic and therapeutic adjuncts may be useful. We describe here the successful utilization of concomitant VA ECMO and Impella in a 43 year old male with acute heart failure and cardiac arrest. Distinguishing itself from the currently reported methods, our methodology incorporates transesophageal echocardiography (TEE) in the emergency department for rapid decision-making in addition to an automatic chest compression device, the Lund University Cardiac Assist System (LUCAS) device (Stryker, Portage, MI) as a bridge to LV unloading in a hybrid operating suite....

LWW
Cardiac #ECMO & #VAD at Specialist Education in #ECMO Conference #SEECMO2023, hosted by University of Florida & supported by ELSO - Extracorporeal Life Support Organization
🫀 Berlin Heart - Mark Bleiweis & Joseph Philip
🫀 VA #ECLS, #Impella,#LVAD - Eric Jeng
🫀 RV Support, Oxy-RVAD - William Jakobleff
🫀 view of the future from lab - Silver Heinsar
🗓️ May 19-21, 2023
🗺️ Gainesville, FL
🖋️ Register at
🖇️ seecmo2023.cme.ufl.edu