Management of Bleeding and Hemolysis During Percutaneous Microaxial Flow Pump Support: A Practical Approach
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Management of Bleeding and Hemolysis During Percutaneous Microaxial Flow Pump Support: A Practical Approach. / Van Edom, Charlotte J; Gramegna, Mario; Baldetti, Luca; Beneduce, Alessandro; Castelein, Thomas; Dauwe, Dieter; Frederiks, Pascal; Giustino, Gennaro; Jacquemin, Marc; Janssens, Stefan P; Panoulas, Vasileios F; Pöss, Janine; Rosenberg, Alexander; Schaubroeck, Hannah A I; Schrage, Benedikt; Tavazzi, Guido; Vanassche, Thomas; Vercaemst, Leen; Vlasselaers, Dirk; Vranckx, Pascal; Belohlavek, Jan; Gorog, Diana A; Huber, Kurt; Mebazaa, Alexandre; Meyns, Bart; Pappalardo, Federico; Scandroglio, Anna M; Stone, Gregg W; Westermann, Dirk; Chieffo, Alaide; Price, Susanna; Vandenbriele, Christophe.
in: JACC-CARDIOVASC INTE, Jahrgang 16, Nr. 14, 24.07.2023, S. 1707-1720.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Management of Bleeding and Hemolysis During Percutaneous Microaxial Flow Pump Support: A Practical Approach
AU - Van Edom, Charlotte J
AU - Gramegna, Mario
AU - Baldetti, Luca
AU - Beneduce, Alessandro
AU - Castelein, Thomas
AU - Dauwe, Dieter
AU - Frederiks, Pascal
AU - Giustino, Gennaro
AU - Jacquemin, Marc
AU - Janssens, Stefan P
AU - Panoulas, Vasileios F
AU - Pöss, Janine
AU - Rosenberg, Alexander
AU - Schaubroeck, Hannah A I
AU - Schrage, Benedikt
AU - Tavazzi, Guido
AU - Vanassche, Thomas
AU - Vercaemst, Leen
AU - Vlasselaers, Dirk
AU - Vranckx, Pascal
AU - Belohlavek, Jan
AU - Gorog, Diana A
AU - Huber, Kurt
AU - Mebazaa, Alexandre
AU - Meyns, Bart
AU - Pappalardo, Federico
AU - Scandroglio, Anna M
AU - Stone, Gregg W
AU - Westermann, Dirk
AU - Chieffo, Alaide
AU - Price, Susanna
AU - Vandenbriele, Christophe
N1 - Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2023/7/24
Y1 - 2023/7/24
N2 - 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.
AB - 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.
KW - Humans
KW - Treatment Outcome
KW - Hemolysis
KW - Percutaneous Coronary Intervention/adverse effects
KW - Heart-Assist Devices/adverse effects
KW - Hemorrhage/diagnostic imaging
KW - Shock, Cardiogenic
U2 - 10.1016/j.jcin.2023.05.043
DO - 10.1016/j.jcin.2023.05.043
M3 - SCORING: Review article
C2 - 37495347
VL - 16
SP - 1707
EP - 1720
JO - JACC-CARDIOVASC INTE
JF - JACC-CARDIOVASC INTE
SN - 1936-8798
IS - 14
ER -