AMI Cardiogenic Shock

ACC/AHA Upgrades mAFP to Class 2a and Downgrades IABP and VA-ECMO to Class 3 in patients with STEMI and Cardiogenic shock

The new Acute Coronary Syndrome (ACS) guidelines downgrade intra-aortic balloon pump (IABP) and venoarterial extracorporeal membrane oxygenation (VA-ECMO) to Class 3 due to no shown benefit, while microaxial intravascular flow pumps (mAFP), Impella®, is now Class 2a in patients with STEMI and severe or refractory cardiogenic shock. 

DanGer Shock RCT

Published in the New England Journal of Medicine, confirms Routine Use of Impella® Improves Survival in Heart Attack with Shock1

Best Practice Protocols Include 1-4

  • Identify CS early and Impella pre-PCI < 90 minutes
  • Aggressive down-titration of inotropes
  • Identify RV dysfunction early and support
  • Identify inadequate LV support and escalate
  • Systematic use of RHC to guide therapy
 

Final Results from the National Cardiogenic Shock Initiative (NCSI) Study Demonstrate the Benefit of Early Cardiac Unloading with Impella®

The NCSI study demonstrates a 71% survival to discharge with greater than 90% native heart recovery when best practices are used, including placement of an Impella heart pump prior to revascularization.

 

Heparin-Free Purge Solution

Sodium bicarbonate is the preferred purge solution when heparin is of concern due to HIT or bleeding related to heparin.

Patient Manangement Resources from the Education Library

 

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.

 

Echocardiography for Impella 5.5® with SmartAssist®

Michael Galvin, a clinical educator at Abiomed, discusses how to measure the position of the Impella 5.5® with SmartAssist® using echocardiography and how this differs from measuring the position of the Impella CP® with SmartAssist®.

 

Echo for Impella®: How to Measure and Determine Proper Position

Michael Galvin, a clinical educator at Abiomed, discusses how to identify Impella components and measure Impella position using echocardiography.

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