AMI Cardiogenic Shock

Patient Management

Improving Outcomes in Cardiogenic Shock Through Best Practices

Prior to discharge from the cath lab and in the ICU, reassess hemodynamics via PA catheter. Best practices include measuring cardiac power output (CPO) and pulmonary artery pulsatility index (PAPi) to evaluate the adequacy of left-sided Impella® support and right heart function, while reducing inotropes.

The AMI cardiogenic shock guidelines present criteria for ongoing patient assessment for myocardial recovery and weaning. If patients meet the criteria for myocardial recovery, wean and explant Impella after a minimum of 48 hours. If recovery is inadequate or there are no signs of recovery in the first 48 to 72 hours, consider escalation of care or transfer.

Patient Management Topics

Chart showing the escalation, weaning and transfer protocols during AMI cardiogenic shock

Cardiogenic Shock Protocol

This download reviews cardiogenic shock guidelines and best practices for identifying, stabilizing, revascularizing and reassessing high-risk cardiogenic shock patients.


Increasing Survival in Cardiogenic Shock through Escalation

Mark Anderson, MD, discusses how cardiac surgery may be able to help achieve a ≥80% survival to discharge in the National Cardiogenic Shock Initiative (NCSI) Study.


Impella Patient Management in the CCU

Joseph Parrillo, MD, Brian Porvin, DO, Steven Keller, MD, PhD, and Seth Bilazarian, MD, discuss managing patients in the CCU with Impella.


Heparin-Free Purge Solution

Sodium bicarbonate purge solution for Impella® heart pumps received FDA PMA approval in April 2022, as an alternative to heparin, for patients who are intolerant to heparin or in whom heparin is contraindicated (e.g. due to heparin-induced thrombocytopenia or bleeding).

Resources from the Education Library


Purge System Management Video Series

See how to change the purge cassette and purge fluid bag in these quick skills videos.


Assessing and Maintaining the Impella Access Site

Assessing the Impella access site and performing the suggested interventions can help prevent complications and improve patient outcomes.


Impella Management in the ICU

Viktoriya Kagan, AGACNP-BC, CCRN, and Eddy Gutierrez, MD, discuss how to care for patients with cardiogenic shock and manage Impella® in the ICU.

Additional Services

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Impella Connect®

Your cloud-based, remote monitoring of Impella heart pump status. With Impella Connect, authorized hospital staff can review cases at any time from any internet-connected device.

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Clinical Support Center

Your on-call resource for 24/7 clinical and technical support. Contact the Clinical Support Center (CSC) at
1-800-422-8666 for patient management expertise to help you achieve the best possible patient outcomes.

Additional Resources

Explore the education library for more tips and tricks.