Importance of Identifying Right Ventricular Failure (RVF) Early
- RVF can occur after acute myocardial infarction (AMI), after durable LVAD implantation, post-cardiotomy or post-transplant
- RVF increases the risk of cardiogenic shock, high-grade atrioventricular-conduction block and in-hospital mortality1
- RVF can lead to longer ICU stays, higher short-term mortality and worsening end-organ dysfunction
Patient Management Topics
Purge System Management Video Series
See how to change the purge cassette, purge fluid bag and more.
Heparin-Free Purge: Bicarbonate Based Purge Solution
A bicarbonate-based purge solution for Impella® may be a viable alternative to heparin-based purge solution in patients who are heparin-intolerant and when heparin is contraindicated.
Weaning and Escalation
Tim Larkin, MD, describes his weaning protocol for the Impella RP® heart pump during this physician Q&A session.
Handling Impella RP® with SmartAssist® Suction Alarms
Suction is most often caused by inadequate preload or malposition.
As with all other Impella® heart pumps, if a suction alarm occurs:
- Decrease P-level to break suction.
- Evaluate patient volume status. Maintain a positive CVP.
- Check Impella RP with SmartAssist position and adjust as needed using chest X-ray, fluoroscopy, or echocardiography.
- When suction is resolved, return to previous P-level.
If position and preload are acceptable and suction cannot be resolved at P-2 or P-3, momentarily stop Impella RP with SmartAssist to break the suction event and restart immediately.
Note that this is different from handling suction alarms with other left-sided Impella heart pumps. This does not replace the Instructions for Use manual.
- Mehta, S.R., et al. (2001). J Am Coll Cardiol, 37(1), 37-43.