MAP was 72. Urine output looked okay. And that’s how ventricular underfilling fools ICU nurses. A suction alarm is often a preload problem — not a device malfunction. When the LV is underfilled, the Impella has nothing to pull. The ventricle collapses inward, triggering suction alarms even while the blood pressure looks acceptable. In critical care, alarms are symptoms. Hemodynamics are the diagnosis. If you’re studying for CCRN, this is the level of physiology you need to understand — not just
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