De Lazzari Beatrice, Capoccia Massimo, Badagliacca Roberto, Bozkurt Selim, De Lazzari Claudio
Human Movement and Sport Sciences, "Foro Italico" University of Rome, 00147 Rome, Italy.
Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, UK.
J Cardiovasc Dev Dis. 2023 Mar 26;10(4):140. doi: 10.3390/jcdd10040140.
Cardiogenic shock (CS) is part of a clinical syndrome consisting of acute left ventricular failure causing severe hypotension leading to inadequate organ and tissue perfusion. The most commonly used devices to support patients affected by CS are Intra-Aortic Balloon Pump (IABP), Impella 2.5 pump and Extracorporeal Membrane Oxygenation. The aim of this study is the comparison between Impella and IABP using CARDIOSIM software simulator of the cardiovascular system. The results of the simulations included baseline conditions from a virtual patient in CS followed by IABP assistance in synchronised mode with different driving and vacuum pressures. Subsequently, the same baseline conditions were supported by the Impella 2.5 with different rotational speeds. The percentage variation with respect to baseline conditions was calculated for haemodynamic and energetic variables during IABP and Impella assistance. The Impella pump driven with a rotational speed of 50,000 rpm increased the total flow by 4.36% with a reduction in left ventricular end-diastolic volume (LVEDV) by ≅15% to ≅30%. A reduction in left ventricular end systolic volume (LVESV) by ≅10% to ≅18% (≅12% to ≅33%) was observed with IABP (Impella) assistance. The simulation outcome suggests that assistance with the Impella device leads to higher reduction in LVESV, LVEDV, left ventricular external work and left atrial pressure-volume loop area compared to IABP support.
心源性休克（CS）是一种临床综合征的一部分，该综合征由急性左心室衰竭引起严重低血压，进而导致器官和组织灌注不足。用于支持受CS影响患者的最常用设备是主动脉内球囊反搏（IABP）、Impella 2.5泵和体外膜肺氧合。本研究的目的是使用心血管系统的CARDIOSIM软件模拟器比较Impella和IABP。模拟结果包括来自CS虚拟患者的基线条件，随后是IABP在不同驱动压力和真空压力下的同步模式辅助。随后，相同的基线条件由不同转速的Impella 2.5提供支持。计算了IABP和Impella辅助期间血流动力学和能量学变量相对于基线条件的百分比变化。以50000转/分钟的转速驱动的Impella泵使总流量增加了4.36%，左心室舒张末期容积（LVEDV）减少了约15%至约30%。在IABP（Impella）辅助下，观察到左心室收缩末期容积（LVESV）减少了约10%至约18%（约12%至约33%）。模拟结果表明，与IABP支持相比，Impella设备辅助导致LVESV、LVEDV、左心室外部功和左心房压力-容积环面积的降低幅度更大。
