Mechanical circulatory support for acute heart failure

Careful assessment of end-organ dysfunction is critical in the evaluation of patients with AHF. Neurological function is the most important assessment. Devastating neurological injury is not uncommon, particularly in the setting of cardiac arrest, prolonged hypotension, or prolonged extracorporeal circulation during cardiac surgery. Patients who are unable to actively participate in their recovery, which includes walking and coughing, should not be offered MCS. On the other hand, it may be impossible to determine the neurological status with a patient in extremis. All sedation should be stopped, imaging of the brain performed, if possible, and evaluation by a neurologist may also be helpful. MCS is not warranted if significant anoxic brain injury has occurred.

Duke Scholars

Author Carmelo Alessio Milano Surgery, Cardiovascular and Thoracic Surgery