Evidence map›Paper›PMID 40681230›Full record

ArticleJACC. Case reports2025

Ramp-Down/Ramp-Up Protocol for Biventricular Dysfunction Management With ECpella Support.

Benedetta Vitali Rosati, Camilla Dinale, Alessandro Barbaria, Umberto Di Dedda, Tommaso Aloisio, Giulio Mondellini, Christiaan Meuwese, Carolina Giordano, Marco Ranucci, Nicolas Van Mieghem and 3 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Benedetta Vitali RosatiDepartment of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
Camilla DinaleDepartment of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
Alessandro BarbariaCardiac Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
Umberto Di DeddaCardiac Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
Tommaso AloisioCardiac Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
Giulio MondelliniDepartment of Interventional Cardiology, Cardiovascular Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
Christiaan MeuweseDepartment of Intensive Care Medicine, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
Carolina GiordanoCardiovascular Unit, Gada, Rome, Italy.
Marco RanucciCardiac Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
Nicolas Van MieghemDepartment of Interventional Cardiology, Cardiovascular Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
Michele MondinoDepartment of Cardiothoracic and Vascular Anesthesia and Cardiothoracic and Vascular Intensive Care Unit, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Roberto LorussoCardio-Thoracic Surgery Department, ECLS Centrum, Heart & Vascular Centre, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands.
Paolo MeaniCardio-Thoracic Surgery Department, ECLS Centrum, Heart & Vascular Centre, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. Electronic address: p.meani@campus.unimib.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveManaging severe biventricular dysfunction with venoarterial extracorporeal membrane oxygenation (ECMO) and Impella requires a strategic approach. The ramp-down/ramp-up protocol standardizes care for such complex cases. KEY STEPS: Key monitoring tools include pulmonary artery catheter echocardiography (transesophageal echocardiography/transthoracic echocardiography), end-tidal CO POTENTIAL PITFALLS: Impella flow is low at the onset due to left ventricular edema or right ventricular dysfunction. Although the protocol does not guarantee myocardial recovery, it can guide subsequent weaning or bridging strategies. TAKE-HOME MESSAGE: The current ramp-down/ramp-up protocol individualizes cardiovascular support and minimizes hemodynamic complications.

Indexed as

cardiogenic shockImpellaleft ventricular unloadingmechanical circulatory support (MCS)venoarterial extracorporeal membrane oxygenation (V-A ECMO)

Identifiers

PMID40681230
PMCPMC12441439

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.