Impella purge solutions in patients receiving extracorporeal membrane oxygenation.

The optimal Impella purge solution in patients receiving concomitant ECMO and Impella (ECPELLA) support remains to be elucidated. We aimed to assess Impella device function in patients supported by ECPELLA receiving heparin-containing or anticoagulant-free (5% dextrose or sodium bicarbonate) purge solutions. Of 25 included patients, 14 received anticoagulant-free and 11 received heparin-containing purge solutions, with a median of five days of ECPELLA support. The only episode of Impella device malfunction occurred in the heparin-containing group. Given the low event rate and apparent maintenance of acceptable device longevity, use of anticoagulant-free purge solutions alongside systemic anticoagulation in ECPELLA patients may be reasonable but requires validation in an appropriately powered study.