Publication Date
11-1-2022
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-21-7615
PMID
36538600
Publication Date(s)
November 2022
Language
English
PMCID
PMC9809073
PubMedCentral® Posted Date
12-21-2022
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Humans, Middle Aged, Shock, Cardiogenic, Heart-Assist Devices, Risk Factors, Heart Failure, Lactates
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
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 (<62 >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.