{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:06:56Z","timestamp":1785575216469,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T00:00:00Z","timestamp":1632528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Extracorporeal cardiopulmonary resuscitation (eCPR) is a rapidly growing treatment strategy due to increasing survival rates in selected patients. Additional left ventricular mechanical unloading, using a transfemoral micro\u2010axial blood pump (Impella\u00ae Denver, Massachusetts, USA), might improve patients\u2019 outcomes. In this regard, we sought to investigate patients who suffered OHCA (out\u2010of hospital cardiac arrest) or IHCA (in\u2010hospital cardiac arrest) with subsequent eCPR via VA\u2010ECMO (veno\u2010arterial extracorporeal membrane oxygenation) and concomitant Impella\u00ae implantation based on survival and feasibility of ECMO weaning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January 2016 until December 2020, 108 patients underwent eCPR at our institution. Data prior to eCPR and early outcome parameters were analyzed comparing patients who were supported with an additional Impella\u00ae (2.5 or CP) (ECMO+Impella\u00ae, <jats:italic>n<\/jats:italic> = 18) and patients without additional (ECMO, <jats:italic>n<\/jats:italic> = 90) support during V\u2010A ECMO therapy. The primary endpoint was in\u2010hospital mortality; secondary endpoints were, among others: ECMO explantation, need for hemodialysis, stroke, and need for blood transfusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Low\u2010flow time was significantly lower in the ECMO+Impella group (60 min vs. 55 min, <jats:italic>p<\/jats:italic> = .01). All\u2010cause mortality was significantly lower in the ECMO+Impella\u00ae group (82% vs. 56%, <jats:italic>p<\/jats:italic> = .01). The time of circulatory support was shorter in the ECMO cohort (2.0 \u00b1 1.73 vs. 4.76 \u00b1 2.88 <jats:italic>p<\/jats:italic> = .05). ECMO decannulation was significantly more feasible in patients with ECMO+Impella\u00ae (72% vs. 32%, <jats:italic>p<\/jats:italic> = .01). Patients treated with additional Impella\u00ae showed significantly more acute kidney injury with the need for dialysis (72% vs. 18%, <jats:italic>p<\/jats:italic> \u2264 .01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Concomitant Impella\u00ae\u00a0support might positively influence survival and ECMO weaning in eCPR patients. Treatment\u2010associated complications such as the need for dialysis were more common in this highly selected patient group. Further studies with larger numbers are necessary to evaluate the clinical relevance of concomitant LV\u2010unloading in eCPR patients using an Impella\u00ae device.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14067","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T14:29:55Z","timestamp":1631543395000},"page":"451-459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Impact of left ventricular unloading using a peripheral Impella\u00ae\u2010pump in eCPR patients"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7232-3330","authenticated-orcid":false,"given":"Christopher","family":"Gaisendrees","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery University Hospital of Cologne  Cologne 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