Table 2. Interagency for Mechanically Assisted Circulatory Support profiles.
Profile | Description |
---|---|
1 | Cardiogenic shock “Crash and Burn” |
Life-threatening hypotension despite rapidly escalating inotropic or vasopressor support, critical organ hypoperfusion often confirmed by worsening acidosis or lactate level | |
2 | Progressive decline “Sliding on Inotropes” |
Declining function despite inotropic support, showing worsening renal function, malnutrition, inability to achieve euvolemic status. Also declining clinical condition in whom maintenance of inotropic support cannot be tolerated owing to tachyarrhythmia, ischemic, or other conditions. | |
3 | Stable but inotrope-dependent “Dependent Stability” |
Stable perfusion, organ function, nutrition with intravenous inotropic support (or temporary circulatory support device) but showing repeated failure to wean from inotropic support. | |
4 | Resting symptoms on oral therapy “Frequent Flyer” |
Stabilized close to normal volume status with oral therapies but experiencing daily symptoms of congestion at rest or during ADL. Doses of diuretics generally fluctuate at very high levels. | |
5 | Exertion intolerant “Housebound” |
Comfortable without evidence of hypervolemia at rest but unable to perform any activity because of symptoms, living predominantly within the house. | |
6 | Exertion limited “Walking Wounded” |
Comfortable at rest without evidence of hypervolemia and able to perform ADL or minor activities outside the home but fatigues after the first few minutes of any meaningful activity. | |
7 | Advanced NYHA class III |
Stable with a reasonable level of comfortable activity living comfortably with meaningful activity that is limited to mild physical exertion, without current or recent episodes of unstable fluid balance |
ADL = activity of daily living; NYHA = New York Heart Association.
Adapted from Stevenson et al.8) with the permission of the International Society for Heart and Lung Transplantation.