Preprint Article Version 2 Preserved in Portico This version is not peer-reviewed

IABP Versus Impella Support in Cardiogenic Shock: “In Silico” Study

Beatrice De Lazzari
ORCID logo ,
Massimo Capoccia
,
Roberto Badagliacca
* ORCID logo ,
Selim Bozkurt
ORCID logo ,
Claudio De Lazzari
Version 1 : Received: 4 February 2023 / Approved: 7 February 2023 / Online: 7 February 2023 (02:04:31 CET)
Version 2 : Received: 14 February 2023 / Approved: 15 February 2023 / Online: 15 February 2023 (02:47:13 CET)

A peer-reviewed article of this Preprint also exists.

De Lazzari, B.; Capoccia, M.; Badagliacca, R.; Bozkurt, S.; De Lazzari, C. IABP Versus Impella Support in Cardiogenic Shock: “In Silico” Study. J. Cardiovasc. Dev. Dis. 2023, 10, 140. De Lazzari, B.; Capoccia, M.; Badagliacca, R.; Bozkurt, S.; De Lazzari, C. IABP Versus Impella Support in Cardiogenic Shock: “In Silico” Study. J. Cardiovasc. Dev. Dis. 2023, 10, 140.

Abstract

Cardiogenic shock (CS) is part of a clinical syndrome consisting of acute left ventricular failure causing severe hypotension leading to inadequate organ and tissue perfusion. The most com-monly used devices to support patients affected by CS are Intra-Aortic Balloon Pump (IABP), Impella 2.5 pump and Extracorporeal Membrane Oxygenation. The aim of this study is the com-parison between Impella and IABP using CARDIOSIM© software simulator of the cardiovascular system. The results of the simulations included baseline conditions from a virtual patient in CS followed by IABP assistance in synchronized mode with different driving and vacuum pressures. Subsequently, the same baseline conditions were supported by the Impella 2.5 with different ro-tational speeds. The percentage variation with respect to baseline conditions was calculated for hemodynamic and energetic variables during IABP and Impella assistance. Impella pump driven with a rotational speed of 50000 rpm increased the total flow by 4.36% with a reduction in left ventricular end diastolic volume (LVEDV) by ≅15% to ≅30%. A reduction in left ventricular end systolic volume (LVESV) by ≅10% to ≅18% (≅12% to ≅33%) was observed with IABP (Impella) as-sistance. Taking into account the limitations of a simulation setting, this study highlights that assistance with the Impella device leads to higher reduction in LVESV, LVEDV, left ventricular external work and left atrial pressure-volume loop area compared to IABP support.

Keywords

IABP; Impella; Cardiogenic shock; Ventricular elastance; Heart failure; Lumped parameter model; Software simulation; Cardiovascular modelling.

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Comments (1)

Comment 1
Received: 15 February 2023
Commenter: Claudio De Lazzari
Commenter's Conflict of Interests: Author
Comment: The figures from the fourth onwards have been numbered. The new numbering has been updated within the manuscript.
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