IABP versus Impella Support in Cardiogenic Shock: “In Silico” Study

Beatrice De Lazzari, Massimo Capoccia, Roberto Badagliacca, Selim Bozkurt, Claudio De Lazzari

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
21 Downloads (Pure)

Abstract

Cardiogenic shock (CS) is part of a clinical syndrome consisting of acute left ventricular failure causing severe hypotension leading to inadequate organ and tissue perfusion. The most commonly used devices to support patients affected by CS are Intra-Aortic Balloon Pump (IABP), Impella 2.5 pump and Extracorporeal Membrane Oxygenation. The aim of this study is the comparison between Impella and IABP using CARDIOSIM© software simulator of the cardiovascular system. The results of the simulations included baseline conditions from a virtual patient in CS followed by IABP assistance in synchronised mode with different driving and vacuum pressures. Subsequently, the same baseline conditions were supported by the Impella 2.5 with different rotational speeds. The percentage variation with respect to baseline conditions was calculated for haemodynamic and energetic variables during IABP and Impella assistance. The Impella pump driven with a rotational speed of 50,000 rpm increased the total flow by 4.36% with a reduction in left ventricular end-diastolic volume (LVEDV) by ≅15% to ≅30%. A reduction in left ventricular end systolic volume (LVESV) by ≅10% to ≅18% (≅12% to ≅33%) was observed with IABP (Impella) assistance. The simulation outcome suggests that assistance with the Impella device leads to higher reduction in LVESV, LVEDV, left ventricular external work and left atrial pressure-volume loop area compared to IABP support.
Original languageEnglish
Article number140
Number of pages15
JournalJournal of Cardiovascular Development and Disease
Volume10
Issue number4
Early online date26 Mar 2023
DOIs
Publication statusPublished online - 26 Mar 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • IABP
  • Impella
  • cardiogenic shock
  • ventricular elastance
  • chronic heart failure
  • lumped parameter model
  • software simulation
  • cardiovascular modelling
  • CARDIOSIM©
  • CARDIOSIM

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