Weaning the patient from the Impella® Catheter is at the discretion of the physician. The Impella 2.5 and CP Systems have been approved for ≤ 4 days and the Impella 5.0 and LD Systems have been approved for ≤ 6 days of use.
However, weaning could be delayed beyond the normal use for temporary support as an unintended consequence of continued instability of the patient’s hemodynamics. Inability to wean the patient from the device within a reasonable time frame should result in consideration of a more durable form of left ventricular support.
The following weaning instructions are provided as guidance only.
1. To initiate weaning, press FLOW CONTROL and reduce P-level by 2 level increments over time intervals as cardiac function allows.
2. Keep Impella® Catheter P-level at P-2 or above until the catheter is ready to be explanted from the left ventricle.
3. When the patient’s hemodynamics are stable, reduce the P-level to P-2 and pull the Impella® Catheter back across the aortic valve into the aorta.
4. If the patient’s hemodynamics remain stable, follow instructions in the Removing the Impella® CP Catheter for removing the Impella® Catheter.