Cardiovascular surgery patients may experience a low cardiac output state as a result of anesthesia, cardiopulmonary bypass, and myocardial stunning. Prompt assessment and early intervention are critical to patient survival. A variety of pharmacologic agents are available to support the failing circulation, including several promising new experimental inotropic agents. Intraaortic balloon pumps (IABP) and ventricular assist devices (VAD) are additional therapies reserved for advanced cardiac decompensation that is unresponsive to pharmacologic treatment. A review of etiologic factors precipitating postcardiotomy failure is presented, and traditional and experimental inotropic agents are discussed. An overview of mechanical cardiac support with the IABP, centrifugal and pneumatic VAD, and the Hemopump (Johnson & Johnson Interventional Systems, New Brunswick, NJ) device is presented, all of which addresses information critical to optimal patient outcomes
Cardiac Surgery| May 01 1993
Myocardial Depression after Cardiac Surgery: Pharmacologic and Mechanical Support
S. Jill Ley, RN, MS, CCRN
From the Department of Nursing Education, California Pacific Medical Center, San Francisco, California.
Reprint requests to S. Jill Ley, RN, MS, CCRN, Department of Nursing Education, California Pacific Medical Center, PO Box 7999, San Francisco, CA 94115.
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AACN Adv Crit Care (1993) 4 (2): 293–308.
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S. Jill Ley; Myocardial Depression after Cardiac Surgery: Pharmacologic and Mechanical Support. AACN Adv Crit Care 1 May 1993; 4 (2): 293–308. doi: https://doi.org/10.4037/15597768-1993-2007
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