Nursing management and prevention of complications in patients carrying Impella ventricular assistance device

Introduction: recently, the use of the ventricular assistance device Impella in patients with acute heart failure has been reported to have benefits, such as increasing its use. However, the complications related to the Impella device are multiple and of different magnitudes. In light of all this, it is critical that the registered nurse be adequately trained to ensure proper care for the patient carrying such a device in any circumstance.

Aim: the purpose of the study is to identify the complications associated with the patient carrying the Impella device and the related monitoring, management and prevention methods the registered nurse is called to act upon.

Materials and Methods: the literature of the last 10 years in the main online databases, such as Pubmed and Google Scholar, was reviewed, and the PIO method was used for developing keywords.

Results: 29 articles were selected from the search. From these articles, it appears that the most common complications related to the Impella device concern bleeding, vascular injury, and ischemia of the limb, but infections and hemolysis are also worthy of attention.

Conclusions: analyzing the complications found in the literature suggests that these conditions require specific training of registered nurses in critical care, even simulations and checklists, given the absence of common international guidelines or protocols for the management of the patient carrying and Impella device. The study suggests a checklist drawn up from the evidence found in the literature.