Pennington et al listed criteria for use of ventricular assist device in a patient. The data was presented as a panel discussion at the Circulatory Support Symposium of the Society of Thoracic Surgeons in St Louis in 1988.


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



• 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.


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