Pump 101: The Heart of the Matter
What is PCI?
This is the approximate maximum flow rate (in L/min) for an Impella CP
What is 3.5-4.0 L/min?
This alarm often results from hypovolemia, tamponade, or catheter malposition
What is a suction alarm?
This percentage or less of LVEF often classifies a patient as "high-risk"
What is <35%
This pivotal randomized trial compared Impella 2.5 to the IABP in high-risk PCI
What is the PROTECT II trial?
This is the main reason Impella is used during complex or high-risk PCI; it maintains perfusion and unloads the LV.
What is provide hemodynamic support
The primary hemodynamic goal during support is to maintain a mean arterial pressure of...
What is >65mmHg
The first step when you see "Position Signal Lost" alarm
What is check the connections and confirm Impella placement?
Disease of this major coronary artery makes PCI high-risk even with normal EF
In PROTECT II, this key finding supported the use of Impella over IABP at 90 days post-procedure
What is lower rate of major adverse events with Impella support?
The Impella device that is most often used during complex or high-risk PCI
Wahat is Impella CP
These 2 metric help confirm successful LV unloading
What is decreased LVEDP and improved cardiac power output?
The purge fluid solution that keeps purge flow smooth
What is D5W with 50 units of heparin per mL?
Or, what is D5W with 25 mEq of sodium bicarb per 1000 mL
During a complex or high-risk PCI this waveform change on the Impella console, "loss of pulsatility" with stable flow, often indicates
PROTECT III demonstrated that real world Impella use led to reductions in these 2 outcomes compared to earlier experience
What are major adverse events and repeat revascularizations?
True or False: Impella provides both circulatory support and oxygenation
What is False?
Cardiac Power Output (CPO) is calculated as (MAP x CO) / 451, we aim for this value or higher
What is 0.6 watts?
A persistently high purge pressure (>1000mmHg) might mean, this.
What is an occlusion of the purge line
If your patient becomes hypotensive while on Impella support what are the hemodynamic parameters that should be evaluated
What is volume status and RV function?
The RESTORE EF study focused on recovery of this cardiac parameter after Impella supported high-risk PCI
What is the LVEF?
The P-level on the console refers to this
What is the performance level (motor speed and flow rate)?
What is the inlet 3.5cm below the aortic valve?
What is purge pressure low alarm?
During a complex PCI, this strategy often involves partial flow at P-6 to P-8, which helps maintain perfusion while allowing the heart to begin contributing again
What is a partial wean or ramp trial?
Taken together, the PROTECT and RESTORE studies showed that using Impella during high-risk PCI not only improves procedural safety but also enhances THIS long-term physiologic outcome
What is myocardial recovery or improvement of LV function?