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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
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The mechanical support of cardiogenic shock
12nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
Current Opinion in Critical Care
|April 30, 2021
Summary
Mechanical circulatory support (MCS) offers new hope for cardiogenic shock (CS) patients, but consensus on its use and COVID-19 impacts is needed. Early MCS initiation and expert care are crucial for better outcomes in refractory CS.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Mechanical Circulatory Support
Background:
- Cardiogenic shock (CS) has a high short-term mortality rate (50%) despite conventional therapies.
- Mechanical circulatory support (MCS) devices are increasingly utilized for CS management.
- The COVID-19 pandemic presents unique challenges in CS care.
Purpose of the Study:
- To review current trends in MCS use for CS.
- To discuss CS management strategies during the COVID-19 pandemic.
- To highlight the need for consensus and further research in CS and MCS.
Main Methods:
- Literature review of current trends in MCS for CS.
- Analysis of CS management during the COVID-19 pandemic.
- Synthesis of existing data on CS classification, risk stratification, and MCS selection.
Main Results:
- Veno-arterial extracorporeal membrane oxygenation is a first-line MCS for refractory CS.
- Impella is preferred for left ventricular unloading.
- Ongoing trials will provide critical evidence on MCS efficacy.
- COVID-19 is linked to cardiovascular disorders and CS, requiring more data on prevalence and mortality.
Conclusions:
- Optimal outcomes in refractory CS depend on careful patient selection and early MCS initiation.
- Comprehensive intensive care by experienced teams is vital for successful CS management.
- Further research and international consensus are needed for CS classification, risk stratification, and MCS utilization.
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