PMC:6640909 / 10507-12080
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6640909","sourcedb":"PMC","sourceid":"6640909","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6640909","text":"Recommendations for preoperative organ function optimization\nRecommendation Class Level References\nRenal function\nIn patients with renal dysfunction, optimization via improvement of cardiac output and reduction of filling pressures is recommended. I B [56]\nLiver function\nLiver function evaluation with bilirubin is recommended. I B [57, 58]\nIn patients with increasingly elevated bilirubin levels, temporary MCS, ahead of possible LT-MCS implantation, may be considered. IIb B [59]\nPulmonary function\nTreatment of preimplant pulmonary oedema is recommended before implantation. I B [60, 61]\nLeft ventricular unloading on extracorporeal life support to optimize lung function should be considered. IIa B [62]\nRespiratory physiotherapy should be considered. IIa C\nCoagulation\nWithdrawal of dual antiplatelet therapy and/or vitamin K antagonists to reduce the risk of bleeding is recommended. I B [63, 64]\nThe use of short-acting intravenous anticoagulation as bridging is recommended. I B [64]\nAdministration of procoagulants shortly before implantation of the LT-MCS may be considered. IIb B [64]\nOptimization of coagulation prior to surgery should be considered, especially in patients on temporary MCS. IIa C\nNutritional, metabolic and endocrine considerations\nPreoperative assessment of metabolic, endocrine and nutritional status, including possible interventions for arising issues, should be considered. IIa C\nNutritional support, if necessary, may be considered. IIb C [65, 66]\nLT-MCS: long-term mechanical circulatory 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