The Procedure
Good Outcomes in Cardiogenic Shock are Associated with:
- Early shock recognition1
- Initiation of Impella® device support pre-PCI
- Use of right heart catheterization (RHC) to optimize therapy1
- Timely escalation of care
Unloading Pre-PCI Associated with Improved AMI Cardiogenic Shock Outcome
The following charts provides compelling evidence that pre-PCI unloading is associated with higher survival rates in AMI cardiogenic shock. The consistent trend across multiple studies and large sample sizes strengthens the validity of these findings. Significant p-values in most studies further emphasize the reliability of the results.
Key Chart Observations
- Pre-PCI Survival Rates: Generally higher survival rates across all studies.
- Post-PCI Survival Rates: Tend to be lower compared to Pre-PCI rates.
- Matched Control Groups: Where included, often have the lowest survival rates, indicating the benefit of intervention.
- p-Values: Most studies show statistically significant differences (p < 0.05).
Right Heart Failure is Common in AMI Cardiogenic Shock and Associated with a Three-Fold Increase in Mortality
It is important to identify right heart dysfunction early and before the patient leaves the cath lab.
Differential Utilization of Impella Devices, ECMO, and Combined Therapies as Escalation and De-escalation Strategies
“The decision to escalate, de-escalate or wean is highly dependent on patient presentation, capabilities of the institution, and the expertise of the heart team,” write the authors of this paper on differential usage of Impella devices, extracorporeal membrane oxygenation (ECMO), and combined strategies in patients with cardiogenic shock.
Escalation and De-escalation Strategies
Alexander Bernhardt, M.D., discusses insertion, escalation, de-escalation, and weaning of mechanical circulatory support (MCS) devices in patients with cardiogenic shock.
Step-by-Step Axillary Insertion - Impella 5.5® with SmartAssist® Heart Pump
Discover our step-by-step instruction for the axillary insertion of the Impella 5.5 with SmartAssist.
Step-by-Step Direct Aortic Insertion - Impella 5.5® with SmartAssist® Heart Pump
Discover our step-by-step instruction for the direct aortic insertion of the Impella 5.5 with SmartAssist.
Early Left Ventricular Unloading Improves Survival in Patients in Cardiogenic Shock - Supported by Extracorporeal Membrane Oxygenation (ECMO)
New research shows that early left ventricular unloading with Impella heart pumps improves survival in patients with cardiogenic shock supported by extracorporeal membrane oxygenation (ECMO).
References
- O'Neill, W.W., TCT 2020.
Impella Step-by-Step Guide
Discover More About Cardiogenic Shock
NPS-2629