Effects of Escalating Temporary Mechanical Circulatory Support in Patients With Worsening Cardiogenic Shock.

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Texas Heart Institute journal


BACKGROUND: Cardiogenic shock-related mortality is substantial, and temporary mechanical circulatory support (MCS) devices are frequently used. The authors aimed to describe patient characteristics and outcomes in patients with worsening cardiogenic shock requiring escalation of temporary MCS devices.

METHODS: Worsening cardiogenic shock was defined as persistent hypotension, increasing doses of vasopressors/inotropes, worsening hypoperfusion, or worsening invasive hemo-dynamics. Escalation of temporary MCS devices was defined as adding or exchanging an existing MCS device. Variables were evaluated by logistic regression models and receiver operating characteristic curves.

RESULTS: From July 1, 2016, to July 1, 2018, a total of 81 consecutive patients experienced worsening cardiogenic shock requiring temporary MCS escalation. The etiology of cardiogenic shock was heterogeneous (33.3% acute myocardial infarction and 61.7% decompen-sated heart failure). Younger age (years), lower body mass index (85 mm Hg), and lower postescalation lactate levels (

CONCLUSION: Patients requiring temporary MCS escalation represent a high-risk cohort. Further work is needed to improve outcomes in this patient population.

Medical Subject Headings

Humans; Middle Aged; Shock, Cardiogenic; Heart-Assist Devices; Risk Factors; Heart Failure; Lactates

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