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Impella Quick Help Guide
Impella Quick Help Guide
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Pdf Summary
The Impella Quick Help Guide created by Dr. Raymond A. Pashun, MD, FACC, is a resource designed to assist clinicians using the Impella CP device, a percutaneous left-ventricular assist device. This guide outlines the key indications, contraindications, initial considerations, optimal parameters, and common issues associated with the device. <strong>Indications for Use:</strong> The Impella CP is indicated for patients experiencing left ventricular (LV) failure or cardiogenic shock. <strong>Contraindications:</strong> The device should not be used in patients with severe aortic regurgitation, mechanical aortic valves, peripheral vascular disease, or LV thrombus. <strong>Initial Considerations Post-Placement:</strong> 1. Confirm device position using transesophageal echocardiogram (TTE). 2. Check the groin or access site for complications. 3. Review the Impella screen for device function. 4. Monitor patient hemodynamics. 5. Keep track of urine output and signs of hemolysis. <strong>Optimal Impella Parameters:</strong> - Position inlet 3.5-4 cm from the aortic annulus. - Optimize preload with a central venous pressure (CVP) of 8-10. - Keep pulmonary artery pulsatility index (PAPi) above 1.0. - Maintain mean arterial pressure (MAP) between 70-90 for afterload reduction. - Ensure the insertion site angle is between 30-45 degrees. - Utilize heparin via purge line with anti-Xa levels of 0.15-0.5. <strong>Common Issues and Troubleshooting:</strong> - <strong>Hemolysis</strong>: Symptoms include increased LDH and haptoglobin, and hematuria. Check device position, volume status, and consider lowering P level or upgrading the device if severe. - <strong>Suction Alarms</strong>: Indicated by yellow alarm. Respond by assessing position and volume, and reducing P level if necessary. - <strong>Improper Placement</strong>: Position alarms (red) indicate changes in waveforms. Adjust position with guidance, not advancing if too shallow. - <strong>RV Failure</strong>: Suspect if suction alarms and PAPi under 1.0. Treatment may include diuresis or RV support. - <strong>Insertion Site Complications</strong>: Manage bleeding or hematoma by checking insertion angle and addressing as needed. This guide is not endorsed by the Society of Critical Care Medicine but provides community-developed expertise for the use of Impella devices.
Asset Subtitle
Cardiovascular, 2025, 0:05:00
Asset Caption
This quick help guide provides information regarding impella placement, function and troubleshooting.
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Content Type
Infographic
Knowledge Area
Cardiovascular
Membership Level
Associate
Membership Level
Professional
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Tag
Cardiovascular
Year
2025
Keywords
Impella CP
left-ventricular assist device
cardiogenic shock
aortic regurgitation
hemodynamics
hemolysis
suction alarms
RV failure
insertion site complications
Dr. Raymond A. Pashun
Infographic
Cardiovascular
2025
Associate
Professional
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