title: [Clinical practice guide for the management of low cardiac output syndrome in the postoperative period of heart surgery].
abstract: The low cardiac output syndrome is a potential complication in cardiac surgery patients and associated with increased morbidity and mortality. This guide is to provide recommendations for the management of these patients, immediately after surgery, admitted to the ICU. The recommendations are grouped into different sections, trying to answer from the most basic concepts such as the definition to the different sections of basic and advanced monitoring and ending with the complex management of this syndrome. We propose an algorithm for initial management, as well as two other for ventricular failure (predominantly left or right). Most of the recommendations are based on expert consensus because of the lack of randomized trials of adequate design and sample size in this group of patients. The quality of evidence and strength of the recommendations were made following the GRADE methodology. The guide is presented as a list of recommendations (and level of evidence for each recommendation) for each question on the selected topic. Then for each question, we proceed to the justification of the recommendations.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España. perezvela@yahoo.es
authors.forename: J L
authors.initials: JL
authors.lastname: Pérez Vela
authors.forename: J C
authors.initials: JC
authors.lastname: Martín Benítez
authors.forename: M
authors.initials: M
authors.lastname: Carrasco González
authors.forename: M A
authors.initials: MA
authors.lastname: de la Cal López
authors.forename: R
authors.initials: R
authors.lastname: Hinojosa Pérez
authors.forename: V
authors.initials: V
authors.lastname: Sagredo Meneses
authors.forename: F
authors.initials: F
authors.lastname: del Nogal Saez
mesh_terms: D000328:Adult; D000465:Algorithms; D002303:Cardiac Output, Low / Q000150:complications / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D015908:Counterpulsation; D005112:Extracorporeal Circulation; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic; D011184:Postoperative Period; D018754:Ventricular Dysfunction / Q000209:etiology / Q000628:therapy