Table 2.
Clinical course and cardiac parameters before and during the first 48 h of support with Impella 5.0
| Before implantation | ICU return | 6 hours | 24 hours | 48 hours | |
|---|---|---|---|---|---|
| Alive, number (%) | 40 (100 %) | 40 (100 %) | 39 (98 %) | 38 (95 %) | 37 (93 %) |
| MAP, mmHg | 65 [58–74] | 76 [66–86]a | 76 [71–80]a | 79 [74–88]a | 80 [75–86]a |
| Impella flow, L/min | - | 3.5 [2.6–3.9] | 3.8 [2.4–4.3] | 3.7 [2.5–4.2] | 3.9 [3.3–4.2]b |
| ECMO flow, L/min | 4.1 [2.5–4.3] | 3.9 [3.3–4.7] | 3.6 [3.5–4.2] | 3.6 [3.1–4.1]b | 3.2 [2.5–3.9]b |
| PaO2/FiO2 ratio | 204 [160–311] | 188 [121–280] | 203 [132–324] | 245 [187–327] | 244 [172–335] |
| ScvO2*, % | 62 [56–68] | 74 [68–77] | 70 [65–77] | 75 [70–80] | 70 [69–73] |
| Blood lactate (mmol/L) | 3.8 [1.7–5.9]** | 3.4 [1.7–5.1] | 2.5 [1.5–3.4]a,b | 1.6 [1.2–2.8]a,b | 1.5 [1.0–2.1]a,b |
| SOFA score | 12 [9.8–14.0]** | 9.0 [7.0–11.0]a | - | 8.5 [7.0–11.0]a,b | 8.0 [5.0–10.0]a,b |
| Vasoactive-inotropic score | 51 [13–112] | 47 [17–96] | 43 [18–82] | 24 [8–56]a,b | 9 [0–32]a,b |
| Inotrope score | 10 [1–17] | 5 [0–15] | 1 [0–9]a,b | 0 [0–4]a,b | 0 [0–0.4]a,b |
| Cardiothoracic ratio | 0.58 [0.52–0.66] | - | - | 0.55 [0.50–0.60]a | 0.54 [0.49–0.59]a |
| NT-proBNP (ng/L) | 3736 [1436–8024] | - | - | 1638 [799–5689]a | 1780 [745–3931]a |
Data are median [interquartile range]
MAP mean arterial pressure, ECMO extracorporeal membrane oxygenation, PaO2 partial pressure of oxygen in arterial blood, FiO2 inspired fraction of oxygen, ScvO2 central venous oxygen saturation, SOFA Sepsis-related Organ Failure Assessment, NT-proBNP N-terminal pro-brain natriuretic peptide
*Fifteen (37.5 %) patients were monitored with ScvO2
**Values recorded before mechanical circulatory support
a, bIndicates p value < 0.05 compared to values before Impella implantation and at ICU return after Impella implantation respectively, paired Wilcoxon test