In this edition of the new CTSNet podcast, The Lifeline, host and nurse educator Jill Ley, Clinical Professor at the University of California San Francisco School of Nursing, Founder of the Essentials of Cardiac Surgical Resuscitation, and former Cardiac Surgery Clinical Nurse Specialist at California Pacific Medical Center in San Francisco, CA, USA, speaks with expert guest Rakesh Arora, Director of Cardiothoracic Critical Care and a professor in the Department of Surgery and Anesthesia at Northwestern Medicine, Chicago, IL, USA. They discuss managing arrest in patients with temporary mechanical circulatory support (tMCS), focusing on a paper Arora authored titled “EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery.”  

Chapters 

00:00 Intro 

01:08 Guidelines Background 

02:02 Resuscitation, Monitoring Parameters 

07:37 Approach to Patients in Extremis 

11:39 Quality Assurance, Internal Data 

12:22 End-Tidal 

13:17 Bleeding Management 

15:33 Arrhythmia, Defibrillation 

17:21 Optimizing Tissue Perfusion 

18:09 Key Points 

20:26 Devices & Flow Patterns 

They began by exploring how this paper was developed and how Arora became involved in this project. They discussed the importance of expediting the resuscitation process and examined the recommendations for a tMCS implantation in patients experiencing post-procedural low cardiac output syndrome (LCOS). Key considerations included oxygen saturation levels (SpO2) and point-of-care ultrasound (POCUS), as well as the significance of pulsatility. Additionally, they discussed the interaction between devices and patients and the importance of team training and simulation. They also addressed crucial topics such as coagulation, anticoagulation, and defibrillation. Finally, they examined optimizing tissue perfusion for better patient outcomes.  

Every month, The Lifeline features intensive care specialists sharing their expert insights into the rapid and effective management of critically ill cardiac surgical patients. Don’t miss next month’s episode! 

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