Temporary Mechanical Circulatory Support in Cardiogenic Shock Patients after Cardiac Procedures: Selection Algorithm and Weaning Strategies

Author:

Nersesian Gaik12,Ott Sascha23,Fardman Alexander4ORCID,Lanmueller Pia12ORCID,Lewin Daniel1,Bernhardt Alexander5,Emrich Fabian6,Faerber Gloria7ORCID,Szabó Gábor8,Oezkur Mehmet9,Panholzer Bernd10ORCID,Rojas Sebastian11ORCID,Saeed Diyar12,Schmack Bastian13,Warnecke Gregor14,Zimpfer Daniel15ORCID,Grubitzsch Herko116ORCID,Falk Volkmar121617,Potapov Evgenij12

Affiliation:

1. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Augustenburger Platz 1, 13353 Berlin, Germany

2. German Center for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany

3. Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), 13353 Berlin, Germany

4. Leviev Heart Center, Sheba Medical Center, Ramat-Gan, Israel Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel

5. Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, 20251 Hamburg, Germany

6. Department of Cardiac Surgery, Goethe University Hospital, 60590 Frankfurt, Germany

7. Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, 07747 Jena, Germany

8. Department of Cardiac Surgery, Middle German Heart Centre, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany

9. Department of Cardiovascular Surgery, University Hospital Mainz, 55131 Mainz, Germany

10. Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany

11. Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany

12. Department for Cardiac Surgery, Heart Center Niederrhein, 47805 Krefeld, Germany

13. Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, 45147 Essen, Germany

14. Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany

15. Department of Cardiothoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria

16. Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 10178 Berlin, Germany

17. Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland

Abstract

Mechanical circulatory support has proven effective in managing postcardiotomy cardiogenic shock by stabilizing patients’ hemodynamics and ensuring adequate organ perfusion. Among the available device modalities, the combination of extracorporeal life support and a microaxial flow pump for left ventricular unloading has emerged as a valuable tool in the surgical armamentarium. In this publication, we provide recommendations for the application and weaning of temporary mechanical circulatory support in cardiogenic shock patients, derived from a consensus among leading cardiac centers in German-speaking countries.

Publisher

MDPI AG

Subject

Paleontology,Space and Planetary Science,General Biochemistry, Genetics and Molecular Biology,Ecology, Evolution, Behavior and Systematics

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