• Federico Pappalardo, Clement Delmas, Letizia Bertoldi, Andrea Montisci, Alexander Nap, Sasha Ott, Patrick Hunziker, Hong Sern Lim, Bernd Panholzer, Ina Schwabenland, Agnieszka Tycinska, Christian Stoppe, and Christophe Vandenbriele.
• Kore University, Enna, Italy; Policlinico Centro Cuore GB Morgagni, Catania, Italy.
• J. Cardiothorac. Vasc. Anesth. 2024 Dec 1; 38 (12): 323432513234-3251.

AbstractEvaluation of treatment outcomes in patients supported by temporary mechanical circulatory support (tMCS) currently relies mainly on mortality, which may not sufficiently address other patient benefits or harms. Bleeding and thrombosis are major contributors to mortality. Still, current bleeding scores are not designed for critically ill patients undergoing tMCS, only consider selected populations, and do not account for the high heterogeneity among bleeding and thrombotic adverse events. To improve clinical management, a group of European experts has proposed a revised scoring system based on the MOMENTUM 3 Hemocompatibility Score and the Society of Cardiac Angiography and Interventions (SCAI)classification of cardiogenic shock. The new system termed the Scoring Haemostasis Events and Assessment for Risk (SHEAR) score, is divided into a baseline characterization stage and four escalating scoring stages encompassing all aspects of clinical relevance. This report summarizes the literature on hemocompatibility-related adverse events associated with tMCS, including bleeding, stroke, vascular access complications, hemolysis, thrombosis, and device failure. The SHEAR score provides a simple and rapid bedside scoring system aiming to provide a univocal tool to increase physician awareness of hemocompatibility complications at baseline and beyond, improve clinical research, and enable the capture of device-related complications that will inform relevant outcomes beyond mortality.Copyright © 2024 Elsevier Inc. All rights reserved.

24 keywords...

hide…