Heparin-Free Purge Solution
Highlights:
- Simplified patient management
- Greater independence in anticoagulation management
- Reduction of heparin risks
- Sodium hydrogencarbonate (also called "bicarbonate") increases motor protection
A purge solution with a bicarbonate additive simplifies patient anticoagulation management for physicians using the Impella CP with SmartAssist and Impella 5.5 with SmartAssist, as the heparin administered by the Impella heart pump no longer needs to be accounted or calculated. Physicians thus have the ability to adjust systemic anticoagulation to the optimal target level.
Bicarbonate-Based Purge Solution During Impella Support: A Growing Alternative
This experience suggests the feasibility of using Bicarbonate-Based Purge Solution (BBPS) to maintain purge patency, ensuring pump motor reliability in the setting of Heparin-Induced Thrombocytopenia (HIT), or as a method to reduce bleeding risk and simplify anticoagulation management.1
If you are concerned about heparin-induced thrombocytopenia or bleeding, Abiomed recommends the use of sodium hydrogencarbonate in the purge solution for Impella CP with SmartAssist and Impella 5.5 with SmartAssist. Impella 5.5 with SmartAssist (1st generation), Impella RP, Impella 5.0 and Impella 2.5 are not intended to be used with heparin-free purge.
Heparin-free Purge Help Manage Anticoagulation in Patients Supported With Impella Heart Pumps
Prof. Dr. Christophe Vandenbriele discusses managing anticoagulation in patients supported with Impella heart pumps and the use of bicarbonate-based purge fluid for Impella.
Wide-Variation of Anticoagulation Practices Increase Complication Risks
A survey aimed to characterize anticoagulation practices with Impella pumps in place was conducted at high-volume Impella centers in the US and revealed a considerable variance across centers. The survey reported that 41% of high-volume centers did not adjust systemic heparin dose calculation for the dose included in the purge, which may result in higher than the necessary dose of total heparin.2
Optimize Systemic Anticoagulation - No Need to Account for Device-Delivered Heparin
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References
- Beavers, et al., (2022) J Am Coll Cardiol. 79, 633.
- Reed, B., et al. (2019). J Interv Cardiol, 2019, 1-6.
NPS-3091