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Hemodynamic support with Impella CP was initiated followed by blinded crossover to vasoactive treatment with norepinephrine (0.10\u2009\u03bcg\/kg\/min), epinephrine (0.10\u2009\u03bcg\/kg\/min), or dopamine (10\u2009\u03bcg\/kg\/min) for 30\u2009min each. At the end of the study, phenylephrine (10\u2009\u03bcg\/kg\/min) was administered for 20\u2009min. The primary outcome was cardiac workload, a product of pressure-volume area (PVA) and heart rate (HR), measured using the conductance catheter technique. End-organ perfusion was assessed by measuring venous oxygen saturation from the pulmonary artery (SvO\n                      <jats:sub>2<\/jats:sub>\n                      ), jugular bulb, and renal vein. Treatment effects were evaluated using multilevel mixed-effects linear regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All catecholamines significantly increased LV stroke work and cardiac work, dopamine to the greatest extend by 341.8\u2009\u00d7\u200910\n                      <jats:sup>3<\/jats:sup>\n                      (mmHg\u2009\u00d7\u2009mL)\/min [95% CI (174.1, 509.5),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001], and SvO\n                      <jats:sub>2<\/jats:sub>\n                      significantly improved during all catecholamines. Phenylephrine, a vasoconstrictor, caused a significant increase in cardiac work by 437.8\u2009\u00d7\u200910\n                      <jats:sup>3<\/jats:sup>\n                      (mmHg\u2009\u00d7\u2009mL)\/min [95% CI (297.9, 577.6),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001] due to increase in potential energy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), but no significant change in LV stroke work. Also, phenylephrine tended to decrease SvO\n                      <jats:sub>2<\/jats:sub>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.063) and increased arterial lactate levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Catecholamines increased end-organ perfusion at the expense of increased cardiac work, most by dopamine. However, phenylephrine increased cardiac work with no increase in end-organ perfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13054-020-2816-8","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T08:01:32Z","timestamp":1584518492000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Impact of concomitant vasoactive treatment and mechanical left ventricular unloading in a porcine model of profound cardiogenic shock"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1542-3260","authenticated-orcid":false,"given":"Nanna L. J.","family":"Udesen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole K. L.","family":"Helgestad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann B. 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