Journal article
Use of Sodium Bicarbonate Purge Solution in Impella Devices for Heparin-Induced Thrombocytopenia
Journal of pharmacy practice, Vol.36(4), pp.1035-1038
08/2023
DOI: 10.1177/08971900221089078
PMID: 35388725
Abstract
Heparin purge solution is recommended to be used in Impella devices to prevent biomaterial buildup and subsequent device dysfunction. The use of sodium bicarbonate purge solution in an Impella device is described in two patients with heparin-induced thrombocytopenia (HIT). The first case details a patient with severe mitral regurgitation and cardiogenic shock who had an Impella CP placed who developed HIT. Heparin purge solution was replaced by sodium bicarbonate purge solution in addition to systemic direct thrombin inhibitor (DTI) initiation. There was no significant change in Impella purge pressure or flow over the 13 days of Impella use. The second case describes a patient who developed an acute myocardial infarction and subsequent cardiogenic shock for which an Impella CP was placed who also developed HIT. Heparin purge solution was replaced by sodium bicarbonate purge solution. There was no significant change in purge pressure, flow, or motor current spikes over 11 days of use. In conclusion, we describe the successful use of a novel sodium bicarbonate purge solution utilized in patients with HIT for Impella management alone and in combination with systemic direct thrombin inhibitor therapy. This resulted in no protein deposition in the device gaps or device dysfunction.
Details
- Title: Subtitle
- Use of Sodium Bicarbonate Purge Solution in Impella Devices for Heparin-Induced Thrombocytopenia
- Creators
- Adnan M. Al-Ayoubi - University of IowaKinnari Bhavsar - Robert Wood Johnson University HospitalRyan A. Hobbs - University of IowaKatharyn L. Smith - University of Iowa Hospitals and ClinicsLeonard Y. Lee - Robert Wood Johnson University HospitalHirohisa Ikegami - Robert Wood Johnson University HospitalArun K. Singhal - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of pharmacy practice, Vol.36(4), pp.1035-1038
- Publisher
- Sage
- DOI
- 10.1177/08971900221089078
- PMID
- 35388725
- ISSN
- 0897-1900
- eISSN
- 1531-1937
- Number of pages
- 4
- Language
- English
- Electronic publication date
- 04/07/2022
- Date published
- 08/2023
- Academic Unit
- Cardiothoracic Surgery
- Record Identifier
- 9984322943802771
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