Impella 5.5 & CP
What side of the heart does the 5.5 and CP assist?
Left
What side of the heart does the RP and RP flex assist?
Right
Preload __________ & Afterload ___________
Preload Dependent & Afterload Sensitive
How often do you chart Impella numbers?
Oh no! Your patient is coding.. what P level should you turn to?
P2
Where is the outlet located? (Hint: same as swans!)
Pulmonary Artery
Name one of the two purge solutions we use?
D5W with Heparin or D5W with Sodium Bicarbonate
What is a clinical sign of hemolyis?
Dark Urine
How do you determine placement?
Echocardiogram
How do you determine placement?
Chest X-Ray
What are 2 of the most common causes of suctioning?
Hypovolemia, hypotension or hypertension, malposition, RV failure (with Impella 5.5 and CP)
How often should you change your purge fluid?
Every 24 Hours
What is the max flow you receive from the Impella 5.5 and CP?
~5.5 LPM and 3.5 LPM
What should you use to determine cardiac output & index?
Fick
What is 1 lab test we use to determine if hemolysis is present?
Lactic Acid Dehydrogenase (LDH), Plasma Free Hemoglobin (PfHgb), or Haptoglobin
How often should you change your purge cassette?
Every 5 days
What P level will you not see your LV placement waveform?
<P3
What should you ACT level be before initiating systemic anticoagulation?
<180
You suspect your impella is clotting off.. what purge solution can you use?
TPA or alteplase
How often should you draw anti-coags?
Every 4 hours