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Management of Bleeding and Hemolysis During Percutaneous Microaxial Flow Pump Support: A Practical Approach
CJ. Van Edom, M. Gramegna, L. Baldetti, A. Beneduce, T. Castelein, D. Dauwe, P. Frederiks, G. Giustino, M. Jacquemin, SP. Janssens, VF. Panoulas, J. Pöss, A. Rosenberg, HAI. Schaubroeck, B. Schrage, G. Tavazzi, T. Vanassche, L. Vercaemst, D....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, přehledy, práce podpořená grantem
- MeSH
- hemolýza MeSH
- kardiogenní šok MeSH
- koronární angioplastika * škodlivé účinky MeSH
- krvácení diagnostické zobrazování etiologie prevence a kontrola MeSH
- lidé MeSH
- podpůrné srdeční systémy * škodlivé účinky MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Percutaneous ventricular assist devices (pVADs) are increasingly being used because of improved experience and availability. The Impella (Abiomed), a percutaneous microaxial, continuous-flow, short-term ventricular assist device, requires meticulous postimplantation management to avoid the 2 most frequent complications, namely, bleeding and hemolysis. A standardized approach to the prevention, detection, and treatment of these complications is mandatory to improve outcomes. The risk for hemolysis is mostly influenced by pump instability, resulting from patient- or device-related factors. Upfront echocardiographic assessment, frequent monitoring, and prompt intervention are essential. The precarious hemostatic balance during pVAD support results from the combination of a procoagulant state, due to critical illness and contact pathway activation, together with a variety of factors aggravating bleeding risk. Preventive strategies and appropriate management, adapted to the impact of the bleeding, are crucial. This review offers a guide to physicians to tackle these device-related complications in this critically ill pVAD-supported patient population.
Anaesthesia and Intensive Care Fondazione Policlinico San Matteo IRCCS Pavia Italy
Cardiac and Cardiac Surgery Intensive Care Unit IRCCS San Raffaele Scientific Institute Milan Italy
Cardiovascular Center Onze Lieve Vrouwziekenhuis Aalst Belgium
Department of Cardiac Surgery University Hospitals Leuven Leuven Belgium
Department of Cardiology and Intensive Care Medicine Jessa Ziekenhuis Hasselt Belgium
Department of Cardiology University Heart and Vascular Center Hamburg Hamburg Germany
Department of Cardiovascular Diseases University Hospitals Leuven Leuven Belgium
Department of Laboratory Medicine University Hospitals of Leuven Leuven Belgium
Faculty of Medicine National Heart and Lung Institute Imperial College London London United Kingdom
Intensive Care Medicine University Hospitals Leuven Leuven Belgium
Intensive Care Unit Ghent University Hospital Ghent University Ghent Belgium
Interventional Cardiology Unit San Raffaele Scientific Institute Milan Italy
Postgraduate Medical School University of Hertfordshire Hertfordshire United Kingdom
Citace poskytuje Crossref.org
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- $a Management of Bleeding and Hemolysis During Percutaneous Microaxial Flow Pump Support: A Practical Approach / $c CJ. Van Edom, M. Gramegna, L. Baldetti, A. Beneduce, T. Castelein, D. Dauwe, P. Frederiks, G. Giustino, M. Jacquemin, SP. Janssens, VF. Panoulas, J. Pöss, A. Rosenberg, HAI. Schaubroeck, B. Schrage, G. Tavazzi, T. Vanassche, L. Vercaemst, D. Vlasselaers, P. Vranckx, J. Belohlavek, DA. Gorog, K. Huber, A. Mebazaa, B. Meyns, F. Pappalardo, AM. Scandroglio, GW. Stone, D. Westermann, A. Chieffo, S. Price, C. Vandenbriele
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- $a Percutaneous ventricular assist devices (pVADs) are increasingly being used because of improved experience and availability. The Impella (Abiomed), a percutaneous microaxial, continuous-flow, short-term ventricular assist device, requires meticulous postimplantation management to avoid the 2 most frequent complications, namely, bleeding and hemolysis. A standardized approach to the prevention, detection, and treatment of these complications is mandatory to improve outcomes. The risk for hemolysis is mostly influenced by pump instability, resulting from patient- or device-related factors. Upfront echocardiographic assessment, frequent monitoring, and prompt intervention are essential. The precarious hemostatic balance during pVAD support results from the combination of a procoagulant state, due to critical illness and contact pathway activation, together with a variety of factors aggravating bleeding risk. Preventive strategies and appropriate management, adapted to the impact of the bleeding, are crucial. This review offers a guide to physicians to tackle these device-related complications in this critically ill pVAD-supported patient population.
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