The management of heart failure cardiogenic shock: an international RAND appropriateness panel

Table 3 Weaning from tMCS in HF-CS

Statements	Median	Disagreement index (DI)	Inter-percentile range (IPR)	RAND panel outcome
Regarding the weaning of tMCS in HF-CS, please rate the appropriateness of the following:
Routine PAC to assess / support weaning of tMCS	7.0	0.08	1.00	Appropriate
At least one attempt to wean tMCS before decision to transition to AHF therapies	7.5	0.23	2.00	Appropriate
Routine echocardiogram to assess / support weaning of tMCS	7.0	0.16	1.25	Appropriate
Use of Levosimendan to support weaning of tMCS	4.5	0.59	3.25	Uncertain
Use of escalating inotropes to wean from tMCS	6.0	0.35	2.00	Uncertain
Use of intravenous vasodilators to support weaning from tMCS	6.5	0.35	2.00	Appropriate
Trial of endothelin receptor antagonists or phosphodiesterase inhibitors in patients with evidence of pulmonary hypertension to support weaning from tMCS	5.0	0.43	2.25	Uncertain

For each question, median scores were allocated as inappropriate if scoring <3.5, uncertain if ≥3.5 and <6.5 uncertain and appropriate if ≥6.5. DI was calculated using the RAND DI and disagreement deemed if DI ≥1 amongst the panellists.
HF-CS, Heart Failure related Cardiogenic Shock; PAC, Pulmonary Artery Catheterisation; tMCS, temporary Mechanical Circulatory Support; VAD, Ventricular Assist Device

ISSN: 1364-8535