Low cardiac output syndrome after adult cardiac surgery

Low cardiac output syndrome (LCOS) occurs frequently after cardiac surgery, and is associated with complications. Causes of LCOS include ventricular dysfunction, hemorrhage, cardiac tamponade, or arrhythmias. Management remains supportive, as etiology is identified in a minority of cases. Management includes inotropes and vasopressors, and optimization of intravascular volume and heart rhythm. A temporary epicardial pacemaker for bradyarrhythmias may be helpful. In profound cardiogenic shock, mechanical circulatory support (MCS) is required. However, ideal inotrope/vasopressors combinations, hemodynamic targets and timing of MCS initiation are not described in the literature. In this narrative review, we summarize current definition, occurrence rate, and treatment of LCOS following adult cardiac surgery.

Cardiac surgery; Hemodynamic management; Low cardiac output syndrome; Cardiogenic shock; Mechanical circulatory support; Catecholamines

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