• Liesa Castro, Svante Zipfel, Josephine Braunsteiner, Andreas Schaefer, Björn Sill, Gerold Söffker, Stefan Kluge, Edith Lubos, Meike Rybczinski, Hanno Grahn, Benedikt Schrage, Peter M Becher, Markus J Barten, Dirk Westermann, Stefan Blankenberg, Hermann Reichenspurner, and Alexander M Bernhardt.
• Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. Electronic address: l.castro@uke.de.
• J Crit Care. 2020 Jun 1; 57: 253-258.

PurposeVarious options of temporary mechanical circulatory support (tMCS) exist for the treatment of cardiogenic shock, however, all forms of tMCS carry a risk of complications. The aim of this study was to compare bleeding complications and thromboembolic events under extracorporeal life support + Impella 2.5/CP (ECMELLA) and isolated Impella 5.0 therapy in the same patient cohort.MaterialWe retrospectively analyzed data of patients who underwent ECMELLA implantation and subsequent Impella 5.0 therapy. Implantation strategy and anticoagulation protocol were comparable in both groups.ResultsWe included 15 patients (mean age 57.2 years; 80% of male patients) who were weaned from ECMELLA undergoing subsequent Impella 5.0 implantation. Mean duration of ECMELLA and Impella 5.0 therapy (10.5 vs. 11.2 days) did not differ significantly (p = .731). The average number of transfused packed red blood cells (PRBC) and thrombocyte concentrates (TC) was significantly decreased during Impella 5.0 treatment (PRBC: 30.3 vs 12.3, p = .001; TC: 5.9 vs 2.2, p = .045). Additionally, the transfusion rates per day were significantly reduced under Impella 5.0 support.ConclusionsThe need for transfusions is significantly lower in the phase of Impella 5.0 therapy compared to the initial phase on ECMELLA. Therefore, we recommend replacing ECMELLA by an Impella 5.0 device early, if possible.Copyright © 2019 Elsevier Inc. All rights reserved.

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