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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Temporary mechanical circulatory support (tMCS) is a life-saving treatment option for patients in cardiogenic shock (CS), but many aspects such as patient selection, initiation threshold and optimal modality selection remain unclear. This study describes a standard operating procedure (SOP) for tMCS allocation for CS patients and presents outcome data before and after implementation. Data from 421 patients treated for CS with tMCS between 2018 and 2021 were analyzed. In 2019, we implemented a new SOP for allocating CS patients to tMCS modalities. The association between the time of SOP implementation and the 30-day and 1-year survival as well as hospital discharge was evaluated. Of the 421 patients included, 189 were treated before (pre-SOP group) and 232 after implementation of the new SOP (SOP group). Causes of CS included acute myocardial infarction (n = 80, 19.0%), acute-on-chronic heart failure in patients with dilated or chronic ischemic heart failure (n = 139, 33.0%), valvular cardiomyopathy (n = 14, 3.3%) and myocarditis (n = 5, 1.2%); 102 patients suffered from postcardiotomy CS (24.2%). The SOP group was further divided into an SOP-adherent (SOP-A) and a non-SOP-adherent group (SOP-NA). The hospital discharge rate was higher in the SOP group (41.7% vs. 29.7%), and treating patients according to the SOP was associated with an improved 30-day survival (56.9% vs. 38.9%, OR 2.21, 95% CI 1.01–4.80, p = 0.044). Patient allocation according to the presented SOP significantly improved 30-day survival.

Details

Title
Improving Survival in Cardiogenic Shock—A Propensity Score-Matched Analysis of the Impact of an Institutional Allocation Protocol to Short-Term Mechanical Circulatory Support
Author
Ott, Sascha 1   VIAFID ORCID Logo  ; Lewin, Daniel 2 ; Nersesian, Gaik 3 ; Stein, Julia 2 ; Just, Isabell A 3   VIAFID ORCID Logo  ; Hommel, Matthias 4 ; Schoenrath, Felix 5 ; Starck, Christoph T 6 ; Benjamin O’Brien 7   VIAFID ORCID Logo  ; Falk, Volkmar 8 ; Potapov, Evgenij 3 ; Lanmueller, Pia 3 

 Department of Cardiac Anesthesiology and Intensive Care Medicine, German Heart Center Berlin, 13353 Berlin, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany 
 Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany 
 DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany; Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany 
 Department of Cardiac Anesthesiology and Intensive Care Medicine, German Heart Center Berlin, 13353 Berlin, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany 
 DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany; Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany; Department of Cardiothoracic Surgery, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany 
 DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany; Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany; Institute (STI) of Cardiovascular Perfusion, Steinbeis University Berlin, 13353 Berlin, Germany 
 Department of Cardiac Anesthesiology and Intensive Care Medicine, German Heart Center Berlin, 13353 Berlin, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany; St Bartholomew’s Hospital and Barts Heart Centre, Department of Perioperative Medicine, London EC1A 7BE, UK 
 DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 13353 Berlin, Germany; Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany; Department of Cardiothoracic Surgery, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin Institute of Health, Charité—Universitätsmedizin Berlin, 10178 Berlin, Germany; Translational Cardiovascular Technologies, Institute of Translational Medicine, Department of Health Sciences and Technology, Swiss Federal Institute of Technology, 8092 Zürich, Switzerland 
First page
1931
Publication year
2022
Publication date
2022
Publisher
MDPI AG
e-ISSN
20751729
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2748306268
Copyright
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.