All Things Impella
This is the preferred purge solution for Impella
D5W
This should be placed before leaving the cath lab to monitor volume status and right heart pressures.
PA catheter/swan
Your patient needs to be defibrillated. This is the recommended action for Impella management.
do nothing
DanGer shock trial showed this reduction in all cause mortality when Impella CP was used in CGS.
12.7% (13%)
This type of valve makes your patient ineligible for Impella support.
mechanical valve
What are the two indications for Impella CP?
high risk PCI and cardiogenic shock
This lock tightens the impella catheter down and reduces the risk of catheter movement. Must be checked prior to moving off the table
tuohy borst valve, locking ring,
ACC/AHA guidelines:
"In selected patients with STEMI and severe or refractory cardiogenic shock, insertion of a microaxial intravascular flow pump is reasonable to reduce death" Which class is this referring to?
class 2a
DanGer was this type of trial.
randomized control trial
These wires are recommended as a replacement if the Abiomed .018 wire gets dropped or damaged.
V-18 or Platinum Plus
MAP x CO/451= ? (greatest predictor of in hospital mortality in AMI CGS)
CPO (cardiac power output)
Once the peel away sheath is removed, this is done to mitigate access site bleeding.
maintain the angle of entry
The recommended MAP range to optimize Impella support.
60-80
How many more mean days alive did the patients on the impella CP arm of the DanGer Shock trial gain?
600
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.
wean drips
How many different length sheaths come in the sheath kit?
2, 13cm short sheath and 25cm long sheath
*Double points* what is the size of the impella peel away sheath?
A patient should never leave the Cath Lab in this setting on the AIC.
AUTO
This waveform tells us there is a pressure difference between the inlet and outlet of the pump and should always be pulsatile.
green motor current
In a DanGer sub-study, patients younger than 77 were found to have this absolute mortality reduction.
20%
When suction alarms occur, these 3 things could be causing it.
poor positioning, inadequate volume, or right heart failure
These 4 things are included in the Impella CP box.
-sheath kit
-purge cassette
-0.018 impella wire
-Impella pump
A final step that should be performed under fluoro to reduce the chances of the device migrating forward.
remove the slack
The calculation that will indicate right heart dysfunction.
PAPi(Pulmonary Artery Pulsatility index)
BONUS for 100: What is the calculation?
This is the number of Impella cases UVMC did in 2025?
3
This device can be placed if the Impella CP is not enough support or your patient has severe PVD.
Impella 5.5
what are the three things that lead to a proper functioning impella?
preload
afterload
positioning
what is something you should check before the patient gets off the table? (related to perfusion and the size of the sheath)
distal perfusion. Utilize side port of peel away or reaccess port on repositioning sheath to place contrast and hand inject to make sure there is flow down the leg.
A patient will experience a 1% increase in their mortality for every ___ they spend in shock
1 hour
what is the NNT for DanGer shock trial?
8
I need to do CPR on my patient, what do I do with the pump?
nothing. You may have to reduce flows and hit mute alarm.