Rohm CL, et al. - In this retrospective single-center study, researchers assessed the factors predictive of death in patients treated with the Impella (Abiomed, Danvers, Massachusetts) device for acute severe cardiogenic shock (CS). They also looked at the consequences of prolonged use of Impella. Participants were patients (n=204) treated with the Impella 2.5, Impella CP, or Impella 5.0. Significant predictors of mortality identified in this study were initial biochemical parameters and requirement for vasopressors and inotropes in patients treated with the Impella for acute severe CS. To choose between the Impella or higher level of mechanical circulatory support as the best treatment strategy, these predictors can be valuable indicators. Poorer outcomes were observed in patients treated with the Impella for more than 4 days; escalation of care may be beneficial for these patients.