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Bicarbonate Purge in Impella: Safety and Feasibility
Melina Giugni1, Komal I Alam2, Dana Farsakh2
1From the InCor, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|February 19, 2026
Summary
A bicarbonate-based purge solution (BBPS) offers a safe alternative to heparinized purge solutions (HPS) for Impella® device patients with heparin contraindications. This study found similar safety and efficacy outcomes between BBPS and HPS groups.
Area of Science:
- Cardiology
- Biomedical Engineering
- Pharmacology
Background:
- Heparin is standard for Impella® purge fluid but contraindicated in some patients.
- A safe and effective alternative purge solution is needed for these patients.
- Bicarbonate-based purge solution (BBPS) is a potential alternative to heparinized purge solution (HPS).
Purpose of the Study:
- To evaluate the feasibility and safety of BBPS compared to HPS.
- To compare major adverse cardiovascular events (MACE), mortality, stroke, bleeding, and pump function.
- To assess BBPS as an alternative for Impella® recipients with heparin contraindications.
Main Methods:
- Retrospective review of 43 Impella® recipients (2021-2023).
- Comparison of 20 patients on BBPS versus 23 patients on HPS.
- Analysis of MACE, 30-day mortality, stroke, bleeding, and pump function.
Main Results:
- No significant differences observed in MACE, 30-day mortality, stroke, or bleeding between BBPS and HPS groups.
- Pump-adequate function was similar across both BBPS and HPS cohorts.
- BBPS demonstrated comparable safety and efficacy to HPS in this patient population.
Conclusions:
- Bicarbonate-based purge solution (BBPS) appears to be a feasible and safe alternative for Impella® patients with heparin contraindications.
- Further prospective studies are warranted to validate these findings.
- BBPS may expand treatment options for temporary mechanical circulatory support.
