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• W2495298941 abstract "Background Cardiogenic shock remains a clinical challenge with high mortality rate. Mechanical circulatory support (MCS) devices have become an integral component of the therapeutic armamentarium expanding the treatment options for refractory cardiogenic shock (RCS). Methods We included all consecutive patients with biventricular unloading with Impella-2.5 and VA-ECMO admitted for RCS between October 2013 and March 2015. Outcome data included survival to discharge, bridging to VAD and 28-day mortality. Results A total of 17 patients were included. Mean age was 63.3 ± 10.5 and 15 (88%) patients were male. RCS resulted from acute myocardial infarction in 14 (82%), acute myocarditis in 1 (6%) dilated cardiomyopathy in 2 (12%) patients. Mean SAPS II and SOFA score on admission was 74.7 ± 16.86 and 11.16 ± 1.79, respectively. Vasopressor doses and lactate levels were significantly decreased within 72 h on biventricular support (p = 0.025 for norepinephrine and p = 0.005 for lactate). Nine (53%) patients died while on support. Of the remaining 8 patients, 5 (29%) patients were weaned successfully and discharged in cardiac rehabilitation and 3 (18%) patients were successfully bridged to VAD. All 5 patients who were discharged to rehabilitation survived at day 28 after discharge, while 1 of 3 VAD patients died after VAD implantation, corresponding to an overall 28-day survival rate of 41%. Conclusions Biventricular support with Impella-2.5 and VA-ECMO in patients with RCS is feasible and led to significant hemodynamic improvement and reduction of lactate levels. Despite high severity scores, ICU- and 28-day mortality rates were better than predicted." @default.
• W2495298941 created "2016-08-23" @default.
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• W2495298941 date "2016-11-01" @default.
• W2495298941 modified "2023-09-26" @default.
• W2495298941 title "Biventricular unloading in patients with refractory cardiogenic shock" @default.
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• W2495298941 doi "https://doi.org/10.1016/j.ijcard.2016.07.227" @default.
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