Evaluation of Thrombocytopenia in Patients Receiving Percutaneous Mechanical Circulatory Support with an Impella Device

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Critical Care Explorations


OBJECTIVES: Evaluate the time course of thrombocytopenia in patients with Impella devices (Abiomed, Danvers, MA). DESIGN: This was a retrospective, multicenter review of electronic medical records at a large hospital system from April 2018 to August 2020. SETTING: Electronic medical records of patients at SSM Health hospitals were reviewed. PATIENTS: Patients 18-89 years old admitted to an SSM Health hospital from April 2018 to August 2020 who received greater than or equal to 24 hours of percutaneous mechanical circulatory support (pMCS) with an Impella device were included. Exclusion criteria were use of other pMCS devices, history of heparin-induced thrombocytopenia (HIT), and presence of device upon transfer from an outside hospital. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Ninety-three patients were included. The median duration of pMCS was 63.5 hours. Thrombocytopenia occurred in 86% of patients and was evident 24 hours after device placement. The platelet nadir occurred 84 hours after device placement. Platelet recovery occurred 86.5 hours after device removal. The duration of thrombocytopenia was 156 hours. Signs of hemolysis were present in 44.09% of patients, were evident 12-24 hours after device placement, and resolved after device removal. CONCLUSIONS: Thrombocytopenia occurred in the majority of patients and was evident 24 hours after device placement. The time course of thrombocytopenia mirrored that of hemolysis.

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