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Updated: Jun 28, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
What the pediatric nurse needs to know about the Impella cardiac assist device
Giorgia Borrelli1, Ilaria Nittolo2, Chiara Bochicchio1
1Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Insights
Pediatric cardiogenic shock management is improving with devices like the Impella pump. This review offers pediatric nurses essential training for Impella use, enhancing left ventricular recovery in critically ill children.
Area of Science:
- Pediatric Cardiology
- Mechanical Circulatory Support
- Pediatric Critical Care
Background:
- Cardiogenic shock in children has high mortality despite medical advances.
- Extracorporeal membrane oxygenation (ECMO) is common but may not unload the left ventricle effectively.
- The Impella pump is increasingly used for pediatric acute heart failure.
Purpose of the Study:
- To review Impella indications, management, and outcomes in pediatric patients.
- To provide training resources for pediatric nurses on Impella device management.
- To enhance the care of children with acute heart failure requiring mechanical support.
Main Methods:
- Comprehensive narrative review of existing literature.
- Focus on pediatric applications of the Impella device.
- Synthesis of data on Impella use in pediatric acute heart failure.
Main Results:
- Limited data currently exists on pediatric Impella use.
- Impella offers potential for improved left ventricular unloading and recovery.
- Specific training is needed for effective pediatric Impella management.
Conclusions:
- Impella pump use in children is growing.
- Effective management requires specialized pediatric nursing knowledge.
- Further research is needed to optimize Impella outcomes in pediatric patients.
Abstract:
Background: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients with acute heart failure to recovery, decision, transplantation or destination therapy. These devices are however limited in children and extracorporeal membrane oxygenation (ECMO) remains the most commonly used device. Veno-arterial ECMO may provide adequate oxygen delivery, but it does not significantly unload the left ventricle, and this may prevent recovery. To improve the likelihood of left ventricular recovery and minimize the invasiveness of mechanical support, the Impella axial pump has been increasingly used in children with acute heart failure in the last decade. Purpose: There are still limited data describing the Impella indications, management and outcomes in children, therefore, we aimed to provide a comprehensive narrative review useful for the pediatric nurses to be adequately trained and acquire specific competencies in Impella management.
