a1 0000003906 00000 n Search for other works by this author on: Percutaneous left ventricular support devices, A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction, Effects of left ventricular unloading by Impella Recover LP 2.5 on coronary hemodynamics, Nursing care of patients receiving intra-aortic balloon counterpulsation, Safety and feasibility of elective high-risk percutaneous coronary intervention procedures with left ventricular support of the Impella Recover LP 2.5, A prospective feasibility trial investigating the use of the Impella 2.5 system in patients undergoing high-risk percutaneous coronary intervention (the PROTECT I trial): Initial U.S. experience, Feasibility and long-term safety of elective Impella-assisted high-risk percutaneous coronary intervention: a pilot two-centre study, Use of Impella Recover LP 2.5 in elective high risk percutaneous coronary intervention [published online ahead of print September 2, 2009], Update on ventricular assist device technology, Impella: Instructions for Use for the Impella 2.5 Circulatory Support System, The coronary no-reflow phenomenon: a review of mechanisms and therapies, 2011 American Association of Critical-Care Nurses, This site uses cookies. Include the cardiovascular surgery staff and perfusion staff in the initial training. To date, we have placed an Impella 2.5 in about 40 patients. Device failure, although not often reported, can occur. Introduction: may email you for journal alerts and information, but is committed Several console alarms may require nursing intervention (Table 7). Abbreviations: ABGs, arterial blood gas analysis; AC, alternating current; Batt, battery; P-perf, pump performance level; PRN, as needed; PTT, partial thromboplastin time; RN, registered nurse; RPM, revolutions per minute. Additionally, a gross assessment of cannula depth can be inferred by contrasting the placement signal and LV pressure waveforms on SmartAssist capable devices (see controller alarm section.). Parameters to assess regularly include placement signal, placement monitoring (pump position), dual signal, purge pressure, motor current, and speed (Table 6). Even a common cold can cause your uvula to swell. The symptoms usually last about four to seven days and don't typically require a trip to the healthcare provider, unless it affects an infant or if complications develop. We found it helpful for the first few Impella placements to be planned, elective placements for high-risk PCI. Crit Care Nurse 1 February 2011; 31 (1): e1e16. The typical infusion rate for the purge fluid is 7 to 20 mL/h. Areas covered: Because the patient was tolerating the procedure well after this, the physician decided to stent the second diseased SVG. Adequate blood flow was reestablished after the intracoronary administration of 500 g nitroglycerin. When hemolysis occurs, hemoglobin level and hematocrit decrease, haptoglobin level decreases, and plasma levels of free hemoglobin increase. A PFH >40 mg/dL or acute increase in either PFH or LDH suggests increasing hemolysis and warrants intervention.4 The main causes of Impella-related hemolysis are crowding or partial obstruction of the inlet or outlet areas due to poor positioning, thrombus formation in the cannula, operating at the higher range of the power settings, and subtherapeutic anticoagulation.
Michael Bryce Design, Margaret Thatcher Ice Cream Quote, Va Disability Rating For Tendonitis In Wrist, Breach Of Contract California Complaint, Articles S