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low cardiac output syndrome
Etiology:
- occurs most commonly in patients after cardiac surgery
Pathology:
- transient decrease in systemic perfusion secondary to myocardial dysfunction
- imbalance between oxygen delivery & oxygen consumption resulting in metabolic acidosis
Management:
- optimize myocardial contractility/ventricular function
- no benefit for inotrope levosimendan [2,3]
- improve diastolic dysfunction
- maintain adequate preload
- reduce afterload
- improve oxygen supply & demand
- allow time for the ventricle to recover
General
syndrome
References
- Masse L, Antonacci M.
Low cardiac output syndrome: identification and management.
Crit Care Nurs Clin North Am. 2005 Dec;17(4):375-83, x
PMID: 16344207
- Mehta RH, Leimberger JD, van Diepen S et al.
Levosimendan in patients with left ventricular dysfunction
undergoing cardiac surgery.
N Engl J Med 2017 Mar 19
PMID: 28316276 Free Article
http://www.nejm.org/doi/10.1056/NEJMoa1616218
- Landoni G, Lomivorotov VV, Alvaro G et al.
Levosimendan for hemodynamic support after cardiac surgery.
N Engl J Med 2017 Mar 21
PMID: 28320259 Free Article
http://www.nejm.org/doi/10.1056/NEJMoa1616325