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).
Benefits:
- Simplified anticoagulation management with the removal of Impella-delivered heparin for these patients
- Clinicians can optimize systemic anticoagulation to the optimal target without the need to calculate or account for the device-delivered heparin
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
Wide-Variation of Anticoagulation Practices Increase Complication Risks
A survey aimed to characterize anticoagulation practices with Impella 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 with No Need to Account for Device-Delivered Heparin
Bicarbonate-Based Purge Solution for Impella®
Jeremy Moretz, PharmD, BCCP, describes the Impella® heart pump purge system and explains that while Impella has historically required a heparin-based purge solution, a bicarbonate-based purge solution is now a viable alternative.
References
- Beavers, et al., (2022) J Am Coll Cardiol. 79, 633.
- Reed, B., et al. (2019). J Interv Cardiol, 2019, 1-6.
NPS-2897