Managing Impella Suction Alarms

Understanding Impella Alarms

Impella devices can trigger critical alarms that require immediate attention as they indicate impending loss of hemodynamic support 1
Advisory alarms indicate minor problems that can be addressed in a non-emergent fashion 1, 2

Verify that all power cables are properly connected and confirm adequate battery power or connection to AC power, ensuring the percutaneous lead is intact and not damaged, according to the American Heart Association recommendations 1, 2
Assess device function by placing a stethoscope over the pump to confirm the mechanical hum of proper functioning and check for adequate arterial flow using clinical examination or Doppler if peripheral pulse is not palpable 1, 2

Consider exchanging the controller for the backup controller according to MCS center recommendations if the alarm persists after confirming power supply 1, 2

Patients with persistent controller or pump malfunction despite troubleshooting require immediate evaluation at the nearest center with MCS experience, and if the patient is unstable, transport to the nearest hospital for stabilization 1, 2
During transport, avoid excessive tension on the percutaneous lead, kinking or cutting the percutaneous lead, and ensure all peripheral equipment is transported with the patient 2

Pump stoppage can result in stagnant blood flow and possible thrombus formation, and restarting the pump after prolonged stoppage can result in stroke or other systemic thromboembolic complications, as stated by the American College of Cardiology 2
Always manage care in collaboration with the MCS center in the setting of pump failure, and if the patient is comfortable, awake, oriented, and without evidence of heart failure, severe device malfunction or pump stoppage is unlikely 2