{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:49:54Z","timestamp":1792194594302,"version":"4.4.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Percutaneous mechanical circulatory support (pMCS) by an Impella\u2122 device implies the initiation of systemic anticoagulation to prevent systemic thrombotic complications and a purge fluid to prevent device blockage. Traditionally, unfractionated heparin (UFH) was used for both. In April 2022, the use of bicarbonate-based purge solution (BBPS) as an alternative to UFH in dextrose solution was approved by the Food and Drug Administration in case of contraindications for UFH.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We present the case of a 73-year-old female that was admitted to the cardiac intensive care unit with cardiogenic shock, requiring upgrade with pMCS by an axillary Impella CP\u2122. When she developed a severe haemothorax, all UFH was stopped and the purge was switched to BBPS-dextrose solution without increase in purge pressures nor development of haemolysis. The bleeding stagnated and the patient could be weaned from the Impella\u2122 after 2 days.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Here, we present the first case report of the switch to BBPS in an Impella CP\u2122 supported patient with major bleeding since the FDA approval in April 2022. The switch to BBSP in addition with the administration of platelets and protamine resulted in cessation of the bleeding in this case.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad022","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T17:53:16Z","timestamp":1673459596000},"source":"Crossref","is-referenced-by-count":6,"title":["Switch to a bicarbonate-based Impella CP\u2122 purge solution in a patient with haemothorax: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2830-624X","authenticated-orcid":false,"given":"Charlotte","family":"Van Edom","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leuven , Herestraat 49, 3000 Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Van Puyvelde","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospitals Leuven , Herestraat 49, 3000 Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8083-8916","authenticated-orcid":false,"given":"Steven","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Unversity Hospitals Leuven , Herestraat 49, 3000 Leuven , Belgium"},{"name":"Department of Cardiovascular Sciences, University of Leuven , Herestraat 49, 3000 Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5151-6400","authenticated-orcid":false,"given":"Christophe","family":"Vandenbriele","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leuven , Herestraat 49, 3000 Leuven , Belgium"},{"name":"Department of Cardiovascular Diseases, University Hospitals Leuven , Herestraat 49, 3000 Leuven , Belgium"},{"name":"Department of Adult Intensive Care, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust , Sydney St, London SW3 6NP , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"2023012809222761500_ytad022-B1","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.jacc.2020.12.054","article-title":"Managing patients with short-term mechanical circulatory support: JACC review topic of the week","volume":"77","author":"Balthazar","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2023012809222761500_ytad022-B2","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jacc.2022.01.018","article-title":"SCAI SHOCK stage classification expert consensus update: a review and incorporation of validation studies","volume":"79","author":"Naidu","year":"2022","journal-title":"J Am Coll 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patients on percutaneous ventricular assist devices receiving two different dextrose concentrations of heparinized purge solution: a case series","volume":"32","author":"Dietrich","year":"2019","journal-title":"J Pharm Pract"},{"key":"2023012809222761500_ytad022-B9","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1002\/phar.2629","article-title":"Optimizing anticoagulation for patients receiving impella support","volume":"41","author":"Beavers","year":"2021","journal-title":"Pharmacotherapy"},{"key":"2023012809222761500_ytad022-B10","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s11239-019-01837-6","article-title":"Management of anticoagulation with impella\u00ae percutaneous ventricular assist devices and review of new literature","volume":"48","author":"Succar","year":"2019","journal-title":"J Thromb 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