{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:19:36Z","timestamp":1789071576360,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"Supplement_A","license":[{"start":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T00:00:00Z","timestamp":1616976000000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Abiomed Europe GmbH"},{"name":"Abiomed GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Cardiogenic shock (CS) is a clinical entity that includes a wide spectrum of different scenarios. Mechanical circulatory support (MCS) plays a fundamental role in the contemporary treatment of CS, and device selection is a key element in determining optimal treatment in this complex population. Cardiac support with mechanical devices should allow reduction and complete weaning from inotropes. Persistence of elevated left ventricular (LV) filling pressures, pulmonary congestion, metabolic decompensation, and end-organ damage during current MCS are criteria for MCS escalation. Precise diagnosis of the underlying cause of right ventricular (RV) failure is fundamental for undertaking the correct escalation strategy. In the setting of both MCS escalation and de-escalation, it is important to select a strategy in relation to long-term perspectives (bridge-to-recovery, bridge-to-LV assist device, or bridge-to-heart transplantation). Small retrospective studies have demonstrated that the BiPella approach is feasible, reduces cardiac filling pressures and improves cardiac output across a range of causes of CS. Simultaneous LV and RV device implantation and lower RV afterload may be associated with better outcomes in biventricular CS, but prospective studies are still required.<\/jats:p>","DOI":"10.1093\/eurheartj\/suab007","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T08:06:58Z","timestamp":1617005218000},"page":"A35-A40","source":"Crossref","is-referenced-by-count":26,"title":["Escalation and de-escalation of mechanical circulatory support in cardiogenic shock"],"prefix":"10.1093","volume":"23","author":[{"given":"Letizia F","family":"Bertoldi","sequence":"first","affiliation":[{"name":"Cardio Center, Humanitas Clinical and Research Hospital\u2014IRCCS,\u00a0via Manzoni 56, 20089 Rozzano (MI), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Delmas","sequence":"additional","affiliation":[{"name":"Intensive Cardiac Care Unit, Acute and Chronic Mechanical Circulatory Support Team Rangueil University Hospital, 1 Avenue du Professeur Jean Poulh\u00e8s, 31400 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Hunziker","sequence":"additional","affiliation":[{"name":"Deputy Head Intensive Care Unit, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Pappalardo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, IRCCS ISMETT, UPMC Italy,\u00a0Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,27]]},"reference":[{"key":"2021070721254916800_suab007-B1","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.amjcard.2016.11.037","article-title":"Effect of early initiation of mechanical circulatory support on survival in cardiogenic shock","volume":"119","author":"Basir","year":"2017","journal-title":"Am J Cardiol"},{"key":"2021070721254916800_suab007-B2","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/joic.12569","article-title":"The role of different mechanical circulatory support devices and their timing of implantation on myocardial damage and mid-term recovery in acute myocardial infarction related cardiogenic shock","volume":"31","author":"Pieri","year":"2018","journal-title":"J Interv Cardiol"},{"key":"2021070721254916800_suab007-B3","doi-asserted-by":"crossref","first-page":"e005853","DOI":"10.1161\/CIRCHEARTFAILURE.118.005853","article-title":"Early escalation of mechanical circulatory support stabilizes and potentially rescues patients in refractory cardiogenic shock","volume":"13","author":"Tongers","year":"2020","journal-title":"Circ Heart Fail"},{"key":"2021070721254916800_suab007-B4","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1016\/j.jacc.2018.12.084","article-title":"Standardized team-based care for cardiogenic shock","volume":"73","author":"Tehrani","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2021070721254916800_suab007-B5","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1093\/eurheartj\/ehv051","article-title":"Management of cardiogenic shock","volume":"36","author":"Thiele","year":"2015","journal-title":"Eur Heart J"},{"key":"2021070721254916800_suab007-B6","doi-asserted-by":"crossref","first-page":"3032","DOI":"10.1093\/eurheartj\/ehq324","article-title":"Impaired microcirculation predicts poor outcome of patients with acute myocardial infarction complicated by cardiogenic shock","volume":"31","author":"den Uil","year":"2010","journal-title":"Eur Heart J"},{"key":"2021070721254916800_suab007-B7","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1093\/eurheartj\/ehs104","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European society of cardiology. 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