Cardiogenic Shock, End-stage Heart Failure
Conditions
Keywords
cardiogenic shock, end stage heart failure, bridge to bridge, bridge to decision, left ventricular assist device, IMPELLA™, ECLS
Brief summary
In this retrospective observational multicenter study the authors tested the hypothesis that the use of IMPELLA™ pump as bridge to bridge, by giving the opportunity of active rehabilitation, should improve patient's outcomes after the implantation of Left Ventricular Assist Device (LVAD).
Detailed description
End stage heart failure patients admitted in Intensive Care Unit (ICU) for refractory cardiogenic shock requiring short-term mechanical circulatory support as a bridge to a long-term LVAD might benefit from early mobilization and rehabilitation with IMPELLA™ inserted via the axillary artery. The aim of this study is to compare the early rehabilitation and outcomes after LVAD implantation between patients previously treated by IMPELLA™ or ExtraCorporeal Life Support (ECLS)
Interventions
OTHERstandard of care
retrospective study: standard of care
Sponsors
University Hospital, Bordeaux
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients supported with IMPELLA™ or ECLS for refractory cardiogenic shock as a bridge to long duration LVAD
Exclusion criteria
* Patient refusing to give access to their medical chart * Guardianship and curactorship * Deprived of liberty * short term mechanical circulatory system weaned before LVAD implantation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients alive in the surgery ward, not requiring intravenous access and walking (John Hopkins highest level of mobility (JH-HLM) scale = 8 at 30 days after the LVAD implantation | Day 30 after Left Ventricular Assist Device (LVAD) implantation | Proportion of patients alive in the surgery ward, not requiring intravenous access and walking (John Hopkins highest level of mobility (JH-HLM) scale = 8) at 30 days after the LVAD implantation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Organ dysfunction before LVAD implantation | The day before LVAD implantation | Need for mechanical ventilation, Organ dysfunction assessed by Sequential Organ Failure Assessment (SOFA) score \[0= best outcome to 24 = worst outcome\] |
| complication Under LVAD | The day of Intensive Care Unit (ICU) discharge | bleeding, right ventricular dysfunction, vasoplegia |
| Complication and rehabilitation under Short-term Mechanical Circulatory support | The day of Left Ventricular Assist Device (LVAD) implantation | Duration of support, bleeding, hemolysis, surgical re-exploration, thombus, renal replacement therapy, blood products transfusion, stroke, tracheal extubation, mobilization (chair, walking and ergometry) |
| Vital status | 1 month after LVAD implantation | mortality after LVAD implantation |
| length of stay | up to Intensive Care Unit (ICU) discharge (not more than 6 months after LVAD implantation) | Intensive Care Unit length of stay |
| SOFA score | The day of Short Term Mechanical Circulatory Support (STMCS) implantation | Organ dysfunction assessed by Sequential Organ Failure Assessment (SOFA) score \[0= best outcome to 24 = worst outcome\] |
Countries
France
Outcome results
None listed