# What the pediatric nurse needs to know about the Impella cardiac assist device

## TL;DR

This paper reviews the Impella cardiac assist device for children with heart failure, aiming to guide pediatric nurses in its management and use.

## Contribution

It provides a comprehensive narrative review to train pediatric nurses in Impella device management.

## Key findings

- The Impella device is increasingly used in children with acute heart failure.
- There is a need for more data on Impella indications and outcomes in pediatric patients.

## Abstract

Background: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients with acute heart failure to recovery, decision, transplantation or destination therapy. These devices are however limited in children and extracorporeal membrane oxygenation (ECMO) remains the most commonly used device. Veno-arterial ECMO may provide adequate oxygen delivery, but it does not significantly unload the left ventricle, and this may prevent recovery. To improve the likelihood of left ventricular recovery and minimize the invasiveness of mechanical support, the Impella axial pump has been increasingly used in children with acute heart failure in the last decade. Purpose: There are still limited data describing the Impella indications, management and outcomes in children, therefore, we aimed to provide a comprehensive narrative review useful for the pediatric nurses to be adequately trained and acquire specific competencies in Impella management.