We studied whether sustained hemodynamic support (>7 d) with the Impella 5.0 heart pump can be used as a bridge to clinical decisions in patients who present with cardiogenic shock, and whether such support can improve their outcomes.

We retrospectively reviewed cases of patients who had Impella 5.0 support at our hospital from August 2017 through May 2019. Thirty-four patients (23 with cardiogenic shock and 11 with severely decompensated heart failure) underwent sustained support for a mean duration of 11.7 ± 9.3 days (range, ≤48 d). Of 29 patients (85.3%) who survived to next therapy, 15 were weaned from the Impella, 8 underwent durable left ventricular assist device placement, 4 were escalated to venoarterial extracorporeal membrane oxygenation support, and 2 underwent heart transplantation. The 30-day survival rate was 76.5% (26 of 34 patients). Only 2 patients had a major adverse event: one each had an ischemic stroke and flail mitral leaflet. None of the devices malfunctioned.

Sustained hemodynamic support with the Impella 5.0 not only improved outcomes in patients who presented with cardiogenic shock, but also provided time for multidisciplinary evaluation of potential cardiac recovery, or the need for durable left ventricular assist device implantation or heart transplantation. Our study shows the value of using the Impella 5.0 as a bridge to clinical decisions.

我们研究了 Impella 5.0 心脏泵的持续血流动力学支持（>7 天）是否可以作为心源性休克患者临床决策的桥梁，以及这种支持是否可以改善他们的结果。

我们回顾性回顾了 2017 年 8 月至 2019 年 5 月在我院接受 Impella 5.0 支持的患者病例。34 名患者（23 名心源性休克和 11 名严重失代偿性心力衰竭）接受持续支持，平均持续时间为 11.7 ± 9.3 天（范围，≤48 天）。在 29 名患者 (85.3%) 中存活至下一次治疗，15 名患者从 Impella 中脱机，8 名患者接受了持久的左心室辅助装置放置，4 名患者升级为静脉动脉体外膜肺氧合支持，2 名患者接受了心脏移植。30 天生存率为 76.5%（34 名患者中的 26 名）。只有 2 名患者发生了重大不良事件：各有 1 名患有缺血性中风和连枷二尖瓣。所有设备均未发生故障。

Impella 5.0 的持续血流动力学支持不仅改善了心源性休克患者的预后，而且还为多学科评估潜在的心脏恢复或是否需要持久的左心室辅助装置植入或心脏移植提供了时间。我们的研究显示了使用 Impella 5.0 作为临床决策桥梁的价值。