Journal Article

Clinical application and management of temporary mechanical circulatory support: A clinical consensus

Nianguo Dong, Liangwan Chen, Xianqiang Wang, Jinsong Huang, Neel Sodha, Frank W Sellke, Masanobu Yanase, Yoshijuki Takami, Yingbin Xiao, Xiaotong Hou, Xiuyuan Hao, Sihan Zhou, Pramod Bonde, Thierry Folliguet, Yang Yan, Huishan Wang, Yixuan Wang, Pascal Leprince, Juan Pablo Maureira, Chinese Society for Thoracic and Cardiovascular Surgery; Chinese Association of Cardiovascular Surgeons; Cardiac Critical Care Professional Committee of Chinese Medical Association; Chinese Society of Extracorporeal Life Support; European Society of Cardiovascular and Endovascular Surgery; French Society of Thoracic and Cardiovascular Surgery; Japanese Society for Cardiovascular Surgery; Japanese Society of Artificial Organs, Haitao Zhang, Xin Chen, André Vincentelli, Pavan Atluri

2024

Overview

[...]the IABP has the potential to elevate cardiac output by 10%–20% above baseline levels. The diagnosis hinges on the presence of persistent hypotension (systolic blood pressure <90 mmHg or mean arterial pressure [MAP] <65 mmHg), a cardiac index ≤2.2 L·min–1·m–2, pulmonary capillary wedge pressure ≥15 mmHg, and indicators of end-organ hypoperfusion (e.g., urine output <30 mL/h, altered mental status, cool extremities, lactate >2.0 mmol/L). (5) tMCS can be applied as a bridging therapy for subsequent decision-making in the management of CS occurring in end-stage HF. tMCS Preoperative Evaluation and Device Selection Forming a team Recommendation It is recommended to form a multidisciplinary tMCS team including physicians specializing in cardiovascular surgery, cardiovascular medicine, intensive care medicine, respiratory medicine, anesthesiology, extracorporeal circulation, ultrasound imaging, and other relevant fields, along with nursing and engineering personnel,[3] who are primarily responsible for determining the timing of tMCS placement, selecting the appropriate device, involving in preoperative preparation, device operation and management, and addressing potential complications. Preoperative assessment and timing Recommendations (1) Comprehensive evaluation of tMCS implantation, including indications, contraindications, timing of implantation, and cost-effectiveness, should be conducted by the multidisciplinary tMCS team.

• Publisher: Ovid Technologies (Wolters Kluwer Health),Lippincott Williams & Wilkins,Lippincott Williams & Wilkins Ovid Technologies,Department of Cardiovascular Surgery, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China%Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian 350000, China%Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, China%Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning 110000, China%Department of Cardiovascular Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037 China%Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100000 China%Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510000 China%Department of Cardiovascular Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China%Department of Cardiac Surgery, Yale School of Medicine, 330 Cedar St, 204 Boardman, New Haven, CT 06510, USA%Department of Cardiothoracic Surgery, Alpert Medical School, Brown University Rhode Island Hospital, Providence, RI 02912, USA%Department of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA 19113, USA%Department of Cardiovascular Surgery and Transplantation, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy 54500, France%Department of Cardiovascular Surgery, University Hospital of Lille, University of Lille, Lille 59037, France%Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan%Department of Adult Surgical Intensive Care Unit, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100000, China%Department of Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100000, China%Department of Cardiovascular Surgery, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan%Department of Cardiovascular Surgery, Groupe Hospitalier Pitié-Salpêtrière, University Pierre et Marie Curie, APHP, Paris 75020, France%Department of Cardiac Surgery, APHP, H?pitaux Universitaires Henri Mondor, Créteil F-94010, France,Wolters Kluwer
• Subject: Asian people / Cardiac function / Clinical outcomes / Consensus / Consensus Statement / Contraindications / Coronary vessels / Decision making / Extracorporeal membrane oxygenation / Extracorporeal Membrane Oxygenation - methods / Heart / Heart-Assist Devices / Hemodynamics / Humans / Intubation / Medicine / Mortality / Pulmonary arteries / R / Respiratory therapy / Surgery / Ultrasonic imaging / Veins & arteries