A14 - Haemodynamic and Metabolic Changes Due to Left Ventricular Unloading by Impella Heart Pump in Patients Suffering from Cardiogenic Shock Within 24 Hours: Results from the Jenamacs Impella Registry

Register or Login to View PDF Permissions
Permissions× For commercial reprint enquiries please contact Springer Healthcare:

For permissions and non-commercial reprint enquiries, please visit to start a request.

For author reprints, please email
Information image
Average (ratings)
No ratings
Your rating



Published online:

Support:The development of this supplement was funded by Abiomed.

Correspondence Details:S Möbius-Winkler,

Open Access:

The copyright in this work belongs to Radcliffe Medical Media. Only articles clearly marked with the CC BY-NC logo are published with the Creative Commons by Attribution Licence. The CC BY-NC option was not available for Radcliffe journals before 1 January 2019. Articles marked ‘Open Access’ but not marked ‘CC BY-NC’ are made freely accessible at the time of publication but are subject to standard copyright law regarding reproduction and distribution. Permission is required for reuse of this content.

Background: According to current guidelines, the use of active mechanical support devices for haemodynamic stabilisation of patients in cardiogenic shock (CS) should be considered. Active ventricular unloading by the axial flow pump Impella is a common approach that mechanically unloads the left ventricle and increases cardiac output. Until now, there are no published data showing the acute haemodynamic effect of left ventricular unloading by the Impella support in patients suffering from CS. The aim of the current registry trial was to observe the influence of the Impella heart pump on acute haemodynamic and metabolic parameters, as well as outcome data of patients in CS.

Results: We included 132 consecutive patients with CS and implantation of an Impella axial flow pump in clinical routine (mostly Impella CP). Before and after 24 hours of Impella support, invasive haemodynamic and metabolic parameters were assessed. There was an increase in pulmonary artery oxygen saturation from 52.60 ± 14.24 initially to 62.59 ± 9.45% after 10–30 min of Impella support (p>0.01), and an increase in cardiac output from 4.09 ± 1.65 l/min to 5.13 ± 1.63 (p>0.001) within the first 24 hours. There was a non-significant reduction in mean pulmonary artery pressure within 24 hours, from 29.25 ± 8.94 to 20.73 ± 8.48 mmHg (p=0.17). Despite no change in the mean arterial blood pressure within 24 hours (from 74.29 mmHg to 70.96 mmHg after 24 hours, p=not significant), a reduction of serum lactate from 5.54 ± 6.17 to 4.27 ± 6.21 mmol/l after support was started (p<0.03) was achieved. The overall mortality after 30 days was 78 out of 132 patients (59.09%). The mortality of patients >75 years (n=33) was 75%, and for patients ≤75 years (n=99) mortality was 25%.

Conclusion: The implantation of an Impella axial flow pump in patients suffering from cardiogenic shock leads to early left ventricular mechanical unloading and improvement of haemodynamic and metabolic parameters even after 24 hours. There is much higher mortality in patients >75 years of age.