Short-term mechanical circulatory support: Transitioning the patient to the next stage

Commentary: Restorative resuscitation after cardiac arrest with Controlled Automated Reperfusion of the whoLe body (CARL)—the Freiburg approach with guiding principles from cardiac surgery

“… 3 As experience with CARL matures, it is possible that the indications and management pathways for this platform will be refined. 12 , 13 Future data will influence their evolution to address the “metabolic shock” and the reperfusion injury that accompany resuscitation after cardiac arrest. 3 , 11 The current clinical pathways may be adapted to include this tailored perfusion management, if it proves effective in clinical trials.…”

“… 1 , 2 , 5 The implementation of resuscitation goals from CARL may limit reperfusion injury and may foster more precise care in resuscitation after cardiac arrest. 8 , 9 , 10 , 11 , 12 , 13 …”

Commentary: Unmapped waters—navigating a sea of institutional preferences in cardiogenic shock management

“…Qi and colleagues 1 attempt to shed some light on this dilemma through a decision-making framework in progressing the care of patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) at the University of Minnesota. They advocate for “on-time” initiation of VA-ECMO in refractory cardiogenic shock—ECMO before multisystem organ failure develops—as well as a rapid transition to other, less-morbid, forms of mechanical circulatory support (MCS), namely the Impella 5.0 (Abiomed, Danvers, Mass).…”