Do you need systemic heparin for Impella?
In some patients, the Impella purge system may provide enough heparin to fully anticoagulate the patient. For these patients, additional systemic intravenous heparin may not be needed. For other patients, the Impella purge system may provide too much heparin.
Does Impella need anticoagulation?
The Impella heart pumps require a specific purge pressure range (300-1100 mm Hg) for optimal pump flow and a specific systemic ACT anticoagulation range (160-180 seconds) for optimal and sustained function.
Do you need a PTT before starting heparin drip?
Initiating Heparin therapy: →Extreme Caution: Do not start in patients who have had tPA, for ischemic stroke, within 24 hours. 1. Obtain baseline PT, PTT, CBC and Serum Creatinine if not done within 24 hours prior to initiation of therapy.
What is purge heparin?
To standardize heparin anticoagulation therapy at University Hospital in patients receiving percutaneous mechanical circulatory support via Abiomed Impella® catheter system. Per device manufacturer recommendations, the device purge solution contains unfractionated heparin (UFH) at a concentration of 0 to 50 units/mL.
How is the rate of heparin infusion calculated?
In other words, the systemic heparin infusion will be started at a rate of 12 units/kg/hr minusthe hourly volume of the IMPELLA purge. The hourly rate of the IMPELLA purge must be estimated from the past 30 minutes of purge flow in ml/hr.
When to start systemic infusion with heparin purge?
Please note: if the heparin purge delivers 12 units/kg/hr or more of heparin, the systemic infusion is held initially. It will only be started if the aPTT after 4 hours on the heparin purge is subtherapeutic. 7.
How much UFH is in the uhsimpella pump?
solution contains unfractionated heparin (UFH) at a concentration of 0 to 50 units/mL. Purge flow rates fluctuate continually with average purge speeds of 7 to 20 mL/hr. This protocol was updated in February 2018 to provide IV UFH dosing guidelines which account for the additional heparin being provided in the purge solution. Population
What should the concentration of Impella be outside of the cath lab?
Impella® device will be used outside of the cath lab, Abiomed recommends the addition of unfractionated heparin to the purge solution, at a concentration ranging from 0 to 100 IU/mL, with the default recommendation being 50 IU/mL. Concomitant Systemic Anticoagulation: