Comparison of short mechanical circulatory support in refractory cardiogenic shock: is selection of the devices appropriate?

Abstract Funding Acknowledgements Type of funding sources: None. Background The availability and accessibility to short-term mechanical circulatory support (ST-MCS) in each hospital may condition the choice device regardless characteristics patients with refractory cardiogenic shock (CS). Purposes objectives were stratify risk CS assisted percutaneous or minimally invasive (VA-ECMO, Impella CP 5.0), analyze whether ST-MCS was adequate according patient (severity, respiratory failure right ventricular dysfunction) differences prognosis. Methods Patients requiring at a tertiary center from 2020 August 2022 prospectively included. immediately escalating any VA-ECMO included ECMO group for analysis. Early escalation more potent (< 24 hours) considered as inappropriate selection. Bleeding classified ELSO. Results A total 40 supported: 15 VA- (37,5%), 7 5.0 (17,5%) 18 (45%). mostly placed less severe (SCAI-C 71,4%, median lactate: 1,2 mmol/l (1-1,9), VIS-score: 7,3 (3,1-26), SOFA 5 (3,75-7)), mainly due decompensated chronic heart (71%) bridge transplant (71%). canulated after acute myocardial infarction (AMI)-related (46,7%), profound (SCAI D 40% E 53%, lactate 3(6-10,25), VIS score 80 (40-80), 8 (6-11)). inserted AMI (77,8%) intermediate severity (55,6%), 3,9 (2,3-5,8), 66 (29,4-95), SOFA: (6-8). No found need ventilation (p= 0,426), nor proportion RV dysfunction 0,635). Upgrading required (38%), 4 cath-lab (22%) 2 within first hours (11,1%). Escalation needed 11,1%, all > hours. Mortality during significantly higher (40 vs 0 11%; p=0,041) also in-hospital mortality (60 14 22%; p=0,035), but no 24-hours 30-day mortality. There not complications (Table 1). Conclusions Selection seems appropriate 85% patients. necessary 6 (15%, 33% CP), probably implying selection assistance faster easier access CP. Higher group, are explained by greater rather than increase ST-MCS, which similar among groups.