Inflammatory and Hemolytic Responses of Microaxial Flow Pump Temporary Ventricular Assist Devices via Axillary Access in Cardiogenic Shock
2024

Inflammatory and Hemolytic Responses of Microaxial Flow Pump Temporary Ventricular Assist Devices

Sample size: 47 publication Evidence: moderate

Author Information

Author(s): Schmack Leonie, Ali-Hasan-Al-Saegh Sadeq, Weymann Alexander, Pizanis Nikolaus, Akhyari Payam, Zubarevich Alina, Hanke Jasmin Sarah, Popov Aron-Frederik, Ruhparwar Arjang, Rassaf Tienush, Kamler Markus, Luedike Peter, Schmack Bastian, DellaVolpe Jeffrey D.

Primary Institution: University Duisburg-Essen

Hypothesis

This study aims to investigate outcomes and differentiate the inflammatory and hemolytic responses following axillary artery cannulation for various microaxial flow pump types in patients suffering from cardiogenic shock.

Conclusion

The mortality rate in critical cardiogenic shock appears reduced with axillary artery implantation of Impella devices, particularly the Impella 5.5, which shows advantages in reducing systemic inflammatory response and hemolysis.

Supporting Evidence

  • 66% of patients were treated with the Impella 5.5.
  • The overall 30-day survival rate was 78%.
  • 47% of survivors no longer required mechanical support at 30 days post-therapy.
  • IL-6 levels were significantly lower in patients receiving Impella 5.5 compared to smaller devices.
  • Haptoglobin levels were significantly higher in the Impella 5.5 group.
  • Overall lower rates of hemolysis were observed in the Impella 5.5 group.

Takeaway

Doctors are using special heart pumps to help patients with very weak hearts, and using a bigger pump seems to help them feel better and have fewer side effects.

Methodology

This study is a single-center, retrospective cohort that includes patients who received microaxial Impella implantation via the axillary artery from 2020 to 2022.

Potential Biases

The outcomes may be confounded by the high percentage of patients requiring renal replacement therapy and those treated with the ECMELLA concept.

Limitations

The study is limited by the small number of participants in each subgroup and its retrospective nature, which prevents definitive conclusions.

Participant Demographics

The cohort included 47 patients, predominantly male (85%), with a mean age of 58 years, suffering from various forms of cardiogenic shock.

Statistical Information

P-Value

p = 0.03 for IL-6 levels, p = 0.02 for haptoglobin levels, p < 0.01 for hemolysis rates.

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3390/medicina60121960

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