Manual compression versus MANTA device for access management after impella removal on the ICU

To compare the safety and efficacy of manual compression versus use of the MANTA closure device for access management after Impella removal on the intensive care unit (ICU). The number of patients treated with percutaneous left ventricular assist devices (pLVAD), namely Impella and ECMO, for complex...

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Vydáno v:Scientific reports Ročník 12; číslo 1; s. 14060 - 9
Hlavní autoři: Cuculi, Florim, Burkart, Philipp, Cioffi, Giacomo, Moccetti, Federico, Madanchi, Mehdi, Seiler, Thomas, Hess, Stefanie, Wolfrum, Mathias, Jeyarasa, Magiliny, Meier, Sonja, Kuzmiakova, Silvia, Hakimi, Maani, Seelos, Robert, Kobza, Richard, Toggweiler, Stefan, Attinger-Toller, Adrian, Bossard, Matthias
Médium: Journal Article
Jazyk:angličtina
Vydáno: London Nature Publishing Group UK 18.08.2022
Nature Publishing Group
Nature Portfolio
Témata:
692/308
692/308/409
692/4019/2776
Bleeding
Catheters
Compression
Consortia
Heart
Hemodynamics
Humanities and Social Sciences
Intensive care
Laboratories
multidisciplinary
Science
Science (multidisciplinary)
Ultrasonic imaging
Ventricle
ISSN:2045-2322, 2045-2322
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Shrnutí:To compare the safety and efficacy of manual compression versus use of the MANTA closure device for access management after Impella removal on the intensive care unit (ICU). The number of patients treated with percutaneous left ventricular assist devices (pLVAD), namely Impella and ECMO, for complex cardiac procedures or shock, is growing. However, removal of pLVAD and large bore arteriotomy closure among such patients on the ICU remains challenging, since it is associated with a high risk for bleeding and vascular complications. Patients included in a prospective registry between 2017 and 2020 were analyzed. Bleeding and vascular access site complications were assessed and adjudicated according to VARC-2 criteria. We analyzed a cohort of 87 consecutive patients, who underwent access closure after Impella removal on ICU by using either the MANTA device or manual compression. The cohort´s mean age was 66.1 ± 10.7 years and 76 patients (87%) were recovering from CS. Mean support time was 40 h (interquartile range 24–69 h). MANTA was used in 31 patients (35.6%) and manual compression was applied in 56 patients (64.4%). Overall access related bleedings were significantly lower in the MANTA group (6.5% versus 39.3% (odds ratio (OR) 0.10, 95% CI 0.01–0.50; p  = 0.001), and there was no significant difference in vascular complications between the two groups ( p  = 0.55). Our data suggests that the application of the MANTA device directly on the ICU is safe. In addition, it seems to reduce access related bleeding without increasing the risk of vascular complications.
Bibliografie:ObjectType-Article-1
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-022-18184-x