R
Robert Farivar
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Sep 2, 2026
Mechanical Support Before Shock: A Surgeon’s Strategy for Impella 5.5 and ECMO
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Chris BrownHOST
And I'm interested to hear what they tell a surgeon because, of course, they're from your guys' societies.

Robert FarivarGUEST
Yeah, the guidelines for me reinforced the practice that I had been following for about four or five years.

Robert FarivarGUEST
One of the things that shows up as a repeated theme in biology is it's better to prevent something from happening than to treat it after it started.

Robert FarivarGUEST
So what do I mean by that? It's better to prevent what I'd call at the molecular level is transcriptional activation than to try to inhibit the translation of the protein after it starts.

Robert FarivarGUEST
And, you know, molecular biologists will show you that if you add something like a steroid like dexamethasone to a bunch of cells before they start producing inflammatory proteins, it does a fantastic job at downregulating them.
19 MINS LATER

Chris BrownHOST
in your guys' approach, is that 5-5 the choice and you use it to get as good as you can? And then can you just pull that back, do surgery, and then push it back in after the surgery's over? Or how do you manage that part?