Mechanical Circulatory Support in COVID-19

Area of Science:

• Critical Care Medicine
• Cardiology
• Infectious Diseases

Background:

• Cardiopulmonary failure in COVID-19 patients is associated with high mortality despite aggressive treatments.
• Mechanical circulatory support (MCS) devices present potential benefits for these critically ill patients.
• However, MCS use in COVID-19 introduces unique morbidities and clinical challenges.

Purpose of the Study:

• To highlight the critical considerations for utilizing mechanical circulatory support in COVID-19 patients with cardiopulmonary failure.
• To emphasize the importance of a multidisciplinary approach in managing these complex cases.

Main Methods:

• This is a conceptual review based on clinical experience and existing literature regarding MCS in critical illness.
• The focus is on the challenges and best practices for MCS application in the context of COVID-19.

Main Results:

• Mechanical circulatory support can offer a lifeline for select COVID-19 patients with refractory cardiopulmonary failure.
• Significant risks including bleeding, thrombosis, infection, and device-related complications are associated with MCS.
• Successful implementation necessitates meticulous patient selection and vigilant management by experienced teams.

Conclusions:

• Mechanical circulatory support is a complex but potentially life-saving intervention for severe COVID-19 cardiopulmonary failure.
• A multidisciplinary team approach, with expertise in both critical care and mechanical support, is essential for optimal outcomes.
• Careful consideration of risks, benefits, and patient-specific factors is paramount for the judicious use of MCS in this population.