Pharmacological Criteria for Ventricular Assist Device Insertion Following Postcardiotomy Shock: Experience with the Abiomed BVS System

Abstract

Hospital mortality correlates with the number and level of inotropic support necessary to separate from CPB following adult open heart surgery. The application of a standard pharmacological formula together with hemodynamic criteria for VAD insertion after postcardiotomy cardiogenic shock results in earlier insertion, lower incidence of postoperative MOSF, and improved wean and discharge rates.

Contemporary applications of intra-aortic balloon counterpulsation for cardiogenic shock: a “real world” experience

“…The use of IABP, in this context, should be a preliminary step. Current acquisitions on pathophysiology of CS offer a sound certainty that high doses of inotropes are detrimental on heart recovery (18). Therefore, we strongly believe that, if the end-organ perfusion is not ensured by a medium dose of inotropic support, IABP should be implanted without delay.…”

Cardiogenic shock associated with loco-regional anesthesia rescued with left ventricular assist device implantation

“…The general criteria for their implantation are persistent hemodynamic instability despite maximal pharmacological measures, often including the use of an IABP [12]. The types of VADs vary depending upon whether they are used as (a) a temporary unit with eventual removal following myocardial recovery,(b) a long-term unit with the goal of removal upon successful cardiac transplantation, or (c) a permanent unit in cases of Destination Therapy (DT).…”

Post–Cardiac Surgery Mechanical Support

“…This has encouraged surgeons to implant assist devices earlier, before occurrence of irreversible end-organ damage. 5 The most important determinant of poor outcome was whether the index procedure was being performed for salvage or reoperation. Preoperative need for dialysis was also an important predictor of mortality.…”