Use of a novel bicarbonate‐based Impella 5.5 purge solution in a coagulopathic patient

Autor:	Ramachandra C Reddy, Amber Malhotra, Michael M Koerner, Giuseppe Tavilla, Daniel L Beckles, Kyle A Simonsen, Brady L Gunn
Rok vydání:	2021
Předmět:	Pulmonary and Respiratory Medicine business.industry Cardiogenic shock Heparin medicine.disease Thrombosis Purge Direct thrombin inhibitor Shock (circulatory) Anesthesia medicine Coagulopathy Surgery medicine.symptom Cardiology and Cardiovascular Medicine business Impella medicine.drug
Zdroj:	Journal of Cardiac Surgery. 36:4773-4775
ISSN:	1540-8191 0886-0440
Popis:	The Impella 5.5 with Smart Assist (Abiomed) is a life-saving treatment option in acute heart failure which utilizes a continuous heparin purge solution to prevent thrombosis. In patients with contraindications to heparin, alternative anticoagulation strategies are required. We describe the stepwise management of anticoagulation in a coagulopathic patient with persistent cardiogenic shock following a coronary artery bypass procedure who underwent Impella 5.5 placement. A direct thrombin inhibitor-based purge solution was utilized while evaluating for heparin-induced thrombocytopenia. The use of a novel bicarbonate-based purge solution (BBPS) was successfully used due to severe coagulopathy. There were no episodes of pump thrombosis or episodes of severe bleeding on the BBPS and systemic effects of alkalosis and hypernatremia were minimal.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::4131700bcc0a1ceff6a8ba3c435d33ba https://doi.org/10.1111/jocs.16008 Zobrazit plný text záznamu Plný text ve formátu PDF