在心源休克中，与 Impella 联合使用静脉动脉体外膜肺氧合支持的演变：从经皮股动脉 Impella 到腋动脉 Impella 5.5。
Evolution of concomitant use of veno-arterial extracorporeal membrane oxygenation support with Impella in cardiogenic shock: From percutaneous femoral Impella to axillary Impella 5.5.
机构信息
Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, New York, USA.
出版信息
Artif Organs. 2023 Aug;47(8):1404-1412. doi: 10.1111/aor.14594. Epub 2023 Jun 19.
BACKGROUND
Little is known about safety and efficacy of the use of Impella 5.5 compared to previous iterations in the setting of Impella with Veno-Arterial Extracorporeal Membrane Oxygenation Support as ECPELLA.
METHODS
Consecutive patients who were treated by ECPELLA with surgically implanted axillary Impella 5.5 (N = 13) were compared with patients supported by ECPELLA with percutaneous femoral Impella CP or 2.5 (Control, N = 13).
RESULTS
The total ECPELLA flow was higher in ECPELLA 5.5 group (6.9 vs. 5.4 L/min, p = 0.019). Actual hospital survival was higher than predicted and comparable in both groups (ECPELLA 5.5, 61.5% vs. Control, 53.8%, p = 0.691). Both total device complications (ECPELLA 5.5, 7.7% vs. Control, 46.1%, p = 0.021) and Impella-specific complications (ECPELLA 5.5, 0% vs. Control, 30.8%, p = 0.012) were significantly lower in the ECPELLA 5.5 group.
CONCLUSIONS
Utilization of Impella 5.5 in the setting of ECPELLA provides greater hemodynamic support with a lower risk of complications compared to Impella CP or 2.5.
背景
在使用 Impella 5.5 与先前迭代的 Impella 联合使用静脉动脉体外膜肺氧合支持（即 ECPELLA）的情况下，关于其安全性和疗效知之甚少。
方法
将接受 ECPELLA 治疗并植入外科腋部 Impella 5.5 的连续患者（N=13）与接受经皮股部 Impella CP 或 2.5 支持的 ECPELLA 患者（对照组，N=13）进行比较。
结果
ECPELLA 5.5 组的总 ECPELLA 流量更高（6.9 比 5.4 L/min，p=0.019）。实际住院生存率高于预测值，且两组之间相当（ECPELLA 5.5，61.5%比对照组，53.8%，p=0.691）。两组总设备并发症（ECPELLA 5.5，7.7%比对照组，46.1%，p=0.021）和 Impella 特定并发症（ECPELLA 5.5，0%比对照组，30.8%，p=0.012）均显著降低。
结论
在 ECPELLA 中使用 Impella 5.5 与使用 Impella CP 或 2.5 相比，可提供更大的血液动力学支持，且并发症风险更低。
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