PMID- 34318736
OWN - NLM
STAT- MEDLINE
DCOM- 20230116
LR  - 20230123
IS  - 1477-111X (Electronic)
IS  - 0267-6591 (Linking)
VI  - 38
IP  - 1
DP  - 2023 Jan
TI  - Veno-arterial extracorporeal membrane oxygenation with concomitant Impella versus 
      concomitant intra-aortic-balloon-pump for cardiogenic shock.
PG  - 51-57
LID - 10.1177/02676591211033947 [doi]
AB  - INTRODUCTION: The intra-aortic balloon pump (IABP) and Impella are left 
      ventricular unloading devices with peripheral venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO) in place and later serve as bridging therapy when 
      VA-ECMO is terminated. We aimed to determine the potential differences in 
      clinical outcomes and rate of complications between the two combinations of 
      mechanical circulatory support. METHODS: This was a retrospective, single 
      institutional cohort study conducted in the intensive care unit (ICU) of Queen 
      Elizabeth Hospital, Hong Kong. Inclusion criteria included all patients aged 
      ⩾18 years, who had VA-ECMO support, and who had left ventricular unloading by 
      either IABP or Impella between January 1, 2018 and October 31, 2020. Patients 
      <18 years old, with central VA-ECMO, who did not require left ventricular 
      unloading, or who underwent surgical venting procedures were excluded. The 
      primary outcome was ECMO duration. Secondary outcomes included length of stay 
      (LOS) in the ICU, hospital LOS, mortality, and complication rate. RESULTS: 
      Fifty-two patients with ECMO + IABP and 14 patients with ECMO + Impella were 
      recruited. No statistically significant difference was observed in terms of ECMO 
      duration (2.5 vs 4.6 days, p = 0.147), ICU LOS (7.7 vs 10.8 days, p = 0.367), and 
      hospital LOS (14.8 vs 16.5 days, p = 0.556) between the two groups. No 
      statistically significant difference was observed in the ECMO, ICU, and hospital 
      mortalities between the two groups. Specific complications related to the ECMO 
      and Impella combination were also noted. CONCLUSIONS: Impella was not shown to 
      offer a statistically significant clinical benefit compared with IABP in 
      conjunction with ECMO. Clinicians should be aware of the specific complications 
      of using Impella.
FAU - Au, Shek-Yin
AU  - Au SY
AUID- ORCID: 0000-0001-8331-2250
AD  - Intensive Care Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong.
FAU - Fong, Ka-Man
AU  - Fong KM
AD  - Intensive Care Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong.
FAU - Tsang, Chun-Fung Sunny
AU  - Tsang CS
AD  - Cardiology Services, Department of Medicine, Queen Elizabeth Hospital, Kowloon, 
      Hong Kong.
FAU - Chan, Ka-Chun Alan
AU  - Chan KA
AD  - Cardiology Services, Department of Medicine, Queen Elizabeth Hospital, Kowloon, 
      Hong Kong.
FAU - Wong, Chi Yuen
AU  - Wong CY
AD  - Cardiology Services, Department of Medicine, Queen Elizabeth Hospital, Kowloon, 
      Hong Kong.
FAU - Ng, Wing-Yiu George
AU  - Ng WG
AD  - Intensive Care Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong.
FAU - Lee, Kang Yin Michael
AU  - Lee KYM
AD  - Cardiology Services, Department of Medicine, Queen Elizabeth Hospital, Kowloon, 
      Hong Kong.
LA  - eng
PT  - Journal Article
DEP - 20210728
PL  - England
TA  - Perfusion
JT  - Perfusion
JID - 8700166
SB  - IM
MH  - Humans
MH  - Aged
MH  - Adolescent
MH  - Shock, Cardiogenic
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Retrospective Studies
MH  - Cohort Studies
MH  - *Heart-Assist Devices/adverse effects
MH  - Intra-Aortic Balloon Pumping/methods
OTO - NOTNLM
OT  - IABP
OT  - Impella
OT  - VA-ECMO
OT  - adult
OT  - complications
OT  - left ventricular venting
EDAT- 2021/07/29 06:00
MHDA- 2023/01/17 06:00
CRDT- 2021/07/28 08:43
PHST- 2021/07/29 06:00 [pubmed]
PHST- 2023/01/17 06:00 [medline]
PHST- 2021/07/28 08:43 [entrez]
AID - 10.1177/02676591211033947 [doi]
PST - ppublish
SO  - Perfusion. 2023 Jan;38(1):51-57. doi: 10.1177/02676591211033947. Epub 2021 Jul 
      28.