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

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.

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