Postcardiotomy Shock Syndrome: A Narrative Review of Perioperative Diagnosis and Management

Postcardiotomy shock (PCS) is generally described as the inability to separate from cardiopulmonary bypass due to ineffective cardiac output after cardiotomy, which is caused by a primary cardiac disorder, resulting in inadequate tissue perfusion. Postcardiotomy shock occurs in 0.5% to 1.5% of conte...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2023-12, Vol.37 (12), p.2621-2633
Main Authors: Corujo Rodriguez, Andrea, Richter, Ellen, Ibekwe, Stephanie Opunsunju, Shah, Tina, Faloye, Abimbola O.
Format: Article
Language:English
Subjects:
cardiac surgery
mechanical support devices
postcardiotomy shock
temporary mechanical support
VA ECMO
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Summary:Postcardiotomy shock (PCS) is generally described as the inability to separate from cardiopulmonary bypass due to ineffective cardiac output after cardiotomy, which is caused by a primary cardiac disorder, resulting in inadequate tissue perfusion. Postcardiotomy shock occurs in 0.5% to 1.5% of contemporary cardiac surgery cases, and is accompanied by an in-hospital mortality of approximately 67%. In the last 2 decades, the incidence of PCS has increased, likely due to the increased age and baseline morbidity of patients requiring cardiac surgery. In this narrative review, the authors discuss the epidemiology and pathophysiology of PCS, the rationale and evidence behind the initiation, continuation, escalation, and discontinuation of mechanical support devices in PCS, and the anesthetic implications.
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2023.09.011