{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["2019"],"submitter":["Reed BN"],"pubmed_abstract":["<h4>Objectives</h4>To characterize anticoagulation practices with the Impella percutaneous ventricular assist device (pVAD).<h4>Background</h4>Managing anticoagulation in patients being supported by the Impella pVAD is made challenging by several unique features of the device. These include the release of a dextrose-based purge solution containing unfractionated heparin (UFH), the need to concurrently administer systemic anticoagulation with intravenous UFH, and the lack of an alternative strategy in patients with contraindications to UFH.<h4>Methods</h4>To characterize anticoagulation practices with the Impella pVAD, we conducted a survey of centers in the United States performing a high volume of Impella cases, which we defined as > 1 per month. Centers were contacted via email or phone and individuals who agreed to participate were provided with a link to complete the survey online. The primary measures of interest were variations in practice across centers and variations from the manufacturer's recommendations.<h4>Results</h4>Practices varied considerably among respondents (65 of 182 centers, or 35.7%) and often diverged from manufacturer recommendations. Approximately half of centers (52.4%) reported using a UFH concentration of 50 units/mL in the purge solution, whereas most of the remaining centers (41.3%) reported using lower concentrations. Strategies for the initiation and adjustment of systemic therapy also varied, as did practices for routinely monitoring for hemolysis. Nearly one-fifth of centers (16.7%) had not developed an alternative strategy for the purge solution in patients with contraindications to UFH. Most centers (58.4%) reported using argatroban or bivalirudin in this scenario, a strategy that diverges from the manufacturer's recommendations.<h4>Conclusions</h4>Given these findings, studies to determine a systematic approach to anticoagulation with the Impella device are warranted."],"journal":["Journal of interventional cardiology"],"pagination":["3791307"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC6739784"],"repository":["biostudies-literature"],"pubmed_title":["Survey of Anticoagulation Practices with the Impella Percutaneous Ventricular Assist Device at High-Volume Centers."],"pmcid":["PMC6739784"],"pubmed_authors":["DiDomenico RJ","Cox JF","Oliphant CS","Johnson D","Allender JE","Jennings DL","Coons JC","Reed BN"],"additional_accession":[]},"is_claimable":false,"name":"Survey of Anticoagulation Practices with the Impella Percutaneous Ventricular Assist Device at High-Volume Centers.","description":"<h4>Objectives</h4>To characterize anticoagulation practices with the Impella percutaneous ventricular assist device (pVAD).<h4>Background</h4>Managing anticoagulation in patients being supported by the Impella pVAD is made challenging by several unique features of the device. These include the release of a dextrose-based purge solution containing unfractionated heparin (UFH), the need to concurrently administer systemic anticoagulation with intravenous UFH, and the lack of an alternative strategy in patients with contraindications to UFH.<h4>Methods</h4>To characterize anticoagulation practices with the Impella pVAD, we conducted a survey of centers in the United States performing a high volume of Impella cases, which we defined as > 1 per month. Centers were contacted via email or phone and individuals who agreed to participate were provided with a link to complete the survey online. The primary measures of interest were variations in practice across centers and variations from the manufacturer's recommendations.<h4>Results</h4>Practices varied considerably among respondents (65 of 182 centers, or 35.7%) and often diverged from manufacturer recommendations. Approximately half of centers (52.4%) reported using a UFH concentration of 50 units/mL in the purge solution, whereas most of the remaining centers (41.3%) reported using lower concentrations. Strategies for the initiation and adjustment of systemic therapy also varied, as did practices for routinely monitoring for hemolysis. Nearly one-fifth of centers (16.7%) had not developed an alternative strategy for the purge solution in patients with contraindications to UFH. Most centers (58.4%) reported using argatroban or bivalirudin in this scenario, a strategy that diverges from the manufacturer's recommendations.<h4>Conclusions</h4>Given these findings, studies to determine a systematic approach to anticoagulation with the Impella device are warranted.","dates":{"release":"2019-01-01T00:00:00Z","publication":"2019","modification":"2025-05-29T20:23:56.178Z","creation":"2025-05-29T20:23:56.178Z"},"accession":"S-EPMC6739784","cross_references":{"pubmed":["31772529"],"doi":["10.1155/2019/3791307"]}}