Outcomes of systemic bivalirudin and sodium bicarbonate purge solution for Impella 5.5
Research article published in Artificial organs (2022)
Abstract
BACKGROUND: Impella 5.5 (Abiomed; Danvers, MA) (IMP5) is a commonly used, surgically implanted, tMCS device that requires systemic anticoagulation and purge solution to avoid pump failure. To avoid heparin-induced thrombocytopenia (HIT) from unfractionated heparin (UFH) use, our program has explored the utility of bivalirudin (BIV) for systemic anticoagulation and sodium bicarbonate-dextrose purge solution (SBPS) in IMP5.5. METHODS: This single center, retrospective study included 34 patients supported on IMP5.5 with BIV based AC and SBPS between December 1st 2020 to December 1st 2021.The efficacy and safety end points were incidence of development of HIT, Tissue Plasminogen Activator (tPA) use for suspected pump thrombosis, stroke, and device failure as well as clinically significant bleeding. RESULTS: The median duration of IMP5.5 support was 9.8 days (IQR: 6-15). Most patients were bridged to HTX (58%) followed by recovery (27%) and LVAD implantation (15%). Patients were therapeutic on bivalirudin for 64% of their IMP5.5 support. One patient (2.9%) suffered from ischemic stroke and 26.5% (9) patients developed clinically significant bleeding. tPA was administered to 7(21%) patients. One patient in the entire cohort developed HIT. CONCLUSIONS: Our experience supports the use of systemic BIV and SBPS as a method to avoid heparin exposure in a patient population predisposed to the development of HIT.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Outcomes of systemic bivalirudin and sodium bicarbonate purge solution for Impella 5.5.
Por qué esto importa para la hirudoterapia
Este estudio retrospectivo de un solo centro evaluó a 34 pacientes soportados con Impella 5.5 que recibieron anticoagulación sistémica con bivalirudina y solución de purga de bicarbonato de sodio–dextrosa para evitar la trombocitopenia inducida por heparina (HIT). Los desenlaces incluyeron un accidente cerebrovascular isquémico (2,9%), sangrado clínicamente significativo en el 26,5%, administración de tPA por sospecha de trombosis de la bomba en el 21%, y un nuevo caso de HIT, con los pacientes en rango terapéutico con bivalirudina durante el 64% del tiempo de soporte. Para ASH, no existe una conexión defendible con las sanguijuelas o la hirudoterapia a partir del resumen: no menciona sanguijuelas, hirudina ni terapia derivada de sanguijuelas. Salvedad honesta: se trata de un estudio retrospectivo, de un solo centro, no controlado, que no involucra sanguijuelas ni terapia con sanguijuelas, y no puede establecer eficacia comparativa.
Citación
Outcomes of systemic bivalirudin and sodium bicarbonate purge solution for Impella 5.5
Bashline M et al. · Artificial organs, 2022
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026