Nursing Management of Cardiogenic Shock Treated With ECPELLA: A Case Report

Cardiogenic shock poses a significant challenge in health care, with high mortality rates despite advancements in treatment. This case report details the management of a severe cardiogenic shock using venoarterial extracorporeal membrane oxygenation and an Impella CP device (Abiomed Inc, Danvers, Massachusetts), collectively referred to as ECPELLA, with a focus on nursing interventions. A 31-year-old man presented with acute myocarditis-induced cardiogenic shock. Initial assessment revealed severe biventricular dysfunction and respiratory failure requiring double mechanical support with ECPELLA, combined with continuous inotropic therapy and antibiotics. Mechanical support stabilized hemodynamics, allowing for cardiac and respiratory weaning. After 6 days, the patient showed significant improvement, permitting device removal and discharge after 9 days without complications. Managing cardiogenic shock patients with dual mechanical support demands vigilant nursing care to mitigate risks of complications such as pressure injuries, infections, and limb ischemia. Nursing care included meticulous monitoring, maintenance of assistive devices, and a series of specific interventions encompassing skin care, infection prevention, limb assessment, nutritional support, and vital parameter monitoring. Continuous monitoring and adherence to protocols are crucial. The successful management of cardiogenic shock with ECPELLA requires a multidisciplinary approach and specialized nursing care. Further research is needed to establish best practices and improve outcomes in these complex cases.