Impella RP Versus Pharmacologic Vasoactive Treatment in Profound Cardiogenic Shock due to Right Ventricular Failure

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Region Hovedstaden - en del af Københavns Universitetshospital

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Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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@article{648d8e3ccf4840d38075bf242f8da42f,

title = "Impella RP Versus Pharmacologic Vasoactive Treatment in Profound Cardiogenic Shock due to Right Ventricular Failure",

abstract = "The aim was to translationally compare a pharmacologic strategy versus treatment with the Impella RP in profound RV cardiogenic shock (CS). The pigs were allocated to either vasoactive therapy with norepinephrine (0.10 μg/kg/min) for the first 30 min, supplemented by an infusion of milrinone (0.4 μg/kg/min) for additional 150 min, or treatment with the Impella RP device for 180 min. Total RV workload (Pressure-volume-area × heart rate*103(mmHg/min)) remained unaffected upon treatment with the Impella RP and increased in the vasoactive group (CS 179[147;228] to norepinephrine 268[247;306](p = 0.002 compared to Impella RP) and norepinephrine + milrinone 366[329;422] (p = 0.002 compared to Impella RP). A trend towards higher venous cerebral oxygen saturation was observed with norepinephrine than Impella RP (Impella RP 51[47;61]% vs norepinephrine 62[57;71]%; p = 0.07), which became significantly higher with the addition of milrinone (Impella RP 45[32;63]% vs norepinephrine + milrinone 73[66;81]%; p = 0.002). The Impella RP unloaded the failing RV. In contrast, vasoactive treatment led to enhanced cerebral venous oxygen saturation.",

keywords = "Cardiogenic shock, Hemodynamics, Impella RP, Translational science, Vasopressor, Ventricular unloading",

author = "Jakob Josiassen and Helgestad, {Ole K L} and Udesen, {Nanna L J} and Ann Banke and Frederiksen, {Peter H} and Henrik Schmidt and Jensen, {Lisette O} and Christian Hassager and M{\o}ller, {Jacob E} and Ravn, {Hanne B}",

note = "{\textcopyright} 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2021",

month = dec,

doi = "10.1007/s12265-021-10131-x",

language = "English",

volume = "14",

pages = "1021--1029",

journal = "Journal of Cardiovascular Translational Research",

issn = "1937-5387",

publisher = "Springer New York LLC",

number = "6",

}

RIS

TY - JOUR

T1 - Impella RP Versus Pharmacologic Vasoactive Treatment in Profound Cardiogenic Shock due to Right Ventricular Failure

AU - Josiassen, Jakob

AU - Helgestad, Ole K L

AU - Udesen, Nanna L J

AU - Banke, Ann

AU - Frederiksen, Peter H

AU - Schmidt, Henrik

AU - Jensen, Lisette O

AU - Hassager, Christian

AU - Møller, Jacob E

AU - Ravn, Hanne B

PY - 2021/12

Y1 - 2021/12

N2 - The aim was to translationally compare a pharmacologic strategy versus treatment with the Impella RP in profound RV cardiogenic shock (CS). The pigs were allocated to either vasoactive therapy with norepinephrine (0.10 μg/kg/min) for the first 30 min, supplemented by an infusion of milrinone (0.4 μg/kg/min) for additional 150 min, or treatment with the Impella RP device for 180 min. Total RV workload (Pressure-volume-area × heart rate*103(mmHg/min)) remained unaffected upon treatment with the Impella RP and increased in the vasoactive group (CS 179[147;228] to norepinephrine 268[247;306](p = 0.002 compared to Impella RP) and norepinephrine + milrinone 366[329;422] (p = 0.002 compared to Impella RP). A trend towards higher venous cerebral oxygen saturation was observed with norepinephrine than Impella RP (Impella RP 51[47;61]% vs norepinephrine 62[57;71]%; p = 0.07), which became significantly higher with the addition of milrinone (Impella RP 45[32;63]% vs norepinephrine + milrinone 73[66;81]%; p = 0.002). The Impella RP unloaded the failing RV. In contrast, vasoactive treatment led to enhanced cerebral venous oxygen saturation.

AB - The aim was to translationally compare a pharmacologic strategy versus treatment with the Impella RP in profound RV cardiogenic shock (CS). The pigs were allocated to either vasoactive therapy with norepinephrine (0.10 μg/kg/min) for the first 30 min, supplemented by an infusion of milrinone (0.4 μg/kg/min) for additional 150 min, or treatment with the Impella RP device for 180 min. Total RV workload (Pressure-volume-area × heart rate*103(mmHg/min)) remained unaffected upon treatment with the Impella RP and increased in the vasoactive group (CS 179[147;228] to norepinephrine 268[247;306](p = 0.002 compared to Impella RP) and norepinephrine + milrinone 366[329;422] (p = 0.002 compared to Impella RP). A trend towards higher venous cerebral oxygen saturation was observed with norepinephrine than Impella RP (Impella RP 51[47;61]% vs norepinephrine 62[57;71]%; p = 0.07), which became significantly higher with the addition of milrinone (Impella RP 45[32;63]% vs norepinephrine + milrinone 73[66;81]%; p = 0.002). The Impella RP unloaded the failing RV. In contrast, vasoactive treatment led to enhanced cerebral venous oxygen saturation.

KW - Cardiogenic shock

KW - Hemodynamics

KW - Impella RP

KW - Translational science

KW - Vasopressor

KW - Ventricular unloading

UR - http://www.scopus.com/inward/record.url?scp=85105464348&partnerID=8YFLogxK

U2 - 10.1007/s12265-021-10131-x

DO - 10.1007/s12265-021-10131-x

M3 - Journal article

C2 - 33977379

VL - 14

SP - 1021

EP - 1029

JO - Journal of Cardiovascular Translational Research

JF - Journal of Cardiovascular Translational Research

SN - 1937-5387

IS - 6

ER -

ID: 71199909

Impella RP Versus Pharmacologic Vasoactive Treatment in Profound Cardiogenic Shock due to Right Ventricular Failure

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