{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:58:38Z","timestamp":1784869118103,"version":"3.55.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T00:00:00Z","timestamp":1649289600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>Heparin purge solution is recommended to be used in Impella devices to prevent biomaterial buildup and subsequent device dysfunction. The use of sodium bicarbonate purge solution in an Impella device is described in two patients with heparin-induced thrombocytopenia (HIT). The first case details a patient with severe mitral regurgitation and cardiogenic shock who had an Impella CP placed who developed HIT. Heparin purge solution was replaced by sodium bicarbonate purge solution in addition to systemic direct thrombin inhibitor (DTI) initiation. There was no significant change in Impella purge pressure or flow over the 13\u00a0days of Impella use. The second case describes a patient who developed an acute myocardial infarction and subsequent cardiogenic shock for which an Impella CP was placed who also developed HIT. Heparin purge solution was replaced by sodium bicarbonate purge solution. There was no significant change in purge pressure, flow, or motor current spikes over 11\u00a0days of use. In conclusion, we describe the successful use of a novel sodium bicarbonate purge solution utilized in patients with HIT for Impella management alone and in combination with systemic direct thrombin inhibitor therapy. This resulted in no protein deposition in the device gaps or device dysfunction.<\/jats:p>","DOI":"10.1177\/08971900221089078","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T05:14:41Z","timestamp":1649308481000},"page":"1035-1038","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Use of Sodium Bicarbonate Purge Solution in Impella Devices for Heparin-Induced Thrombocytopenia"],"prefix":"10.1177","volume":"36","author":[{"given":"Adnan M.","family":"Al-Ayoubi","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinnari","family":"Bhavsar","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2493-8808","authenticated-orcid":false,"given":"Ryan A.","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharyn L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohisa","family":"Ikegami","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun K.","family":"Singhal","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"bibr1-08971900221089078","unstructured":"Abiomed. Impella Ventricular Support Systems. Instruction for Use and Clinical Reference Manual 2018:1-245."},{"key":"bibr2-08971900221089078","unstructured":"Heparin sodium in dextrose [package insert]. 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