CPadvanced8 min
LV empty, RV huge
Handover
Anterior STEMI, Impella CP at P-7, and the console will not stop suctioning. CVP 19, PCWP 9, PAPi 0.55. Echo from the doorway: D-sign, huge RV, LV walls kissing. The Impella is not failing. The RV stopped feeding it. Do not climb P into an empty cavity.
Uncorrected shock, suction, or a misplaced inlet progresses to pre-arrest, then a fail.
Goals
- · RV supported
- · PAPi ≥ 1.1
- · Flow ≥ 2.1 L/min