All Things Impella
This is the preferred purge solution for Impella CP.
what is D5W?
This should be placed before leaving the cath lab to monitor volume status and right heart pressures.
What is a PA catheter/swan?
If the peel away sheath is left in place, this should be connected to the side arm.
What is an infusion at 30ml/hr
This type of valve makes your patient ineligible for Impella support.
What is mechanical valve?
These are the two access sites to implant Impella 5.5.
What is axillary and direct aorta?
These locks reduce the risk of catheter movement on Impella CP.
What is the t-lock and tuohy borst valve?
You are utilizing the single access technique, these are the recommended sheath sizes.
What is 6fr and 7fr?
According to Recover Right, to have the best chance of survival, you have this amount of time to identify and intervene on RV dysfunction.
What is 48 hours?
These wires are recommended as a replacement if the Abiomed .018 wire gets dropped or damaged.
What is V-18 or Platinum Plus?
The repo sheath is in and this can be use to maintain wire access in the artery after Impella removal.
What is the re-access port?
BONUS for 100- What size wire will fit?
Once the peel away sheath is removed, and repo sheath placed, this is done to mitigate access site bleeding.
What is maintain the angle of entry?
The recommended MAP range to optimize Impella support.
What is 60-80?
MAP x CO / 451 is the greatest predictor of in hospital mortality.
What is CPO? (Cardiac Power Output)
You should do this if your patient has an Impella CP on P8 flow is 2.7, the blood pressure is 132/88 (103) on Epi, Levo, and Vaso.
What is wean drips?
DAILY DOUBLE
Place your wagers!
In the Danger Shock trial released in April 2024, this metric had an absolute reduction of 12.7% compared to the standard of care.
A patient should never leave the Cath Lab in this setting on the AIC.
What is AUTO?
This waveform tells us there is a pressure difference between the inlet and outlet of the pump and should always be pulsatile.
What is the green motor current?
For every 1 hour delay in initiating mechanical support in CGS, the patients mortality goes up by this percent.
What is 10%?
When suction alarms occur, these 3 things could be causing it.
What are inadequate volume, poor positioning, RV failure
These 4 things are included in the Impella CP box.
What is the sheath kit, purge cassette, .035 wire, Impella pump?
A final step that should be performed under fluoro to reduce the chances of the device migrating forward.
What is remove the slack?
The calculation that will indicate right heart dysfunction.
What is PAPi? (Pulmonary Artery Pulsatility index)
BONUS for 100: What is the calculation?
In a sub study from the DanGer shock trial, in patients 77 and younger, this reduction in all cause mortality when Impella CP was shown in CGS.
What is 20% ?
This can be placed if you do not have distal flow past the Impella sheath.
What is an antegrade sheath??