• Ryota Sato, Daisuke Hasegawa, Stephanie C Guo, Kazuki Nishida, and Siddharth Dugar.
• Division of Critical Care Medicine, Department of Medicine, The Queen's Medical Center, Honolulu, HI. Electronic address: st051035@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2024 Jan 1; 38 (1): 207213207-213.

ObjectivesTo describe the current use and outcomes of temporary mechanical circulatory support (MCS) in patients with sepsis-associated cardiogenic shocks with and without acute myocardial infarction (AMI) in the United States.DesignRetrospective cohort study.SettingThe National Inpatient Sample database from 2017 to 2019.ParticipantsAdult patients with sepsis-associated cardiogenic shock with and without AMI.InterventionsTemporary MCSs, including intra-aortic balloon pump (IABP), percutaneous left ventricular assist device (pLVAD), and extracorporeal membrane oxygenation (ECMO).Measurements And Main ResultsMultivariate logistic regression analyses adjusting for patient characteristics, organ failures, and socioeconomic status. Although the uses of IABP and pLVAD were associated with significantly lower odds of in-hospital mortality in patients with sepsis-associated cardiogenic shock (IABP: adjusted odds ratio [aOR] 0.57, 95% CI 0.44-0.73, p < .001; pLVAD: aOR 0.66, 95% CI 0.45-0.98, p = .037), ECMO was not (aOR 1.51, 95% CI 0.93-2.45, p = 0.096). In the subgroup with AMI, temporary MCSs were not associated with significantly lower or higher odds of in-hospital mortality. In the subgroup without AMI, IABP was associated with significantly lower odds of in-hospital mortality (aOR 0.43, 95% CI 0.28-0.65, p < 0.001).ConclusionsAlthough temporary MCS is deemed to be a feasible option in sepsis-associated cardiogenic shock, the selection of the right patients whose shock is driven mainly by cardiogenic shock rather than septic shock, as represented by low cardiac output and high systemic vascular resistance, plays a critical role in the feasibility of this approach in the absence of clinical trials.Copyright © 2023 Elsevier Inc. All rights reserved.

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