Most patients are postcardiotomy.
Criteria for use of a ventricular assist device (VAD) support:
(1) cardiac output < 2.0 liters per square meter BSA per minute
(2) systemic vascular resistance > 2,100 dynes per second per cm^5
(3) right and/or left atrial pressure > 20 mm Hg
(4) urine output < 20 mL per hour with:
(4a) optimal preload
(4b) maximal inotropic drug therapy
(4c) corrected metabolism (electrolyte, acid-base, etc.)
(4d) intra-aortic balloon pump
where:
• The criteria essentially indicate cardiogenic shock unresponsive to all other interventions.
• In the discussion on page 77 it is mentioned that most patients had an intra-aortic balloon pump before VAD support was considered. I scored the balloon pump separate from the urine output, although there are at least 2 other ways to score it.
