Acute Mechanical Circulatory Support for Cardiogenic Shock

Telukuntla, Kartik; Estep, Jerry D.

doi:10.14797/mdcj-16-1-27

Cited by 45 publications

(38 citation statements)

References 41 publications

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“…VA-ECMO is a temporary mechanical circulatory support system that provides immediate and complete cardiopulmonary support in the event of CS and cardiac arrest [ 61 ].The centrifugal pump of VA-ECMO can propelup to 8 L/min of blood and promote cannula arterial return and venous drainage. A hollow fibre membrane oxygenator is spliced into the circuit, which not only provides blood oxygenation but also carbon dioxide (CO2) clearance via sweep gas flow.…”

Section: Discussionmentioning

confidence: 99%

Mortality in cardiogenic shock patients receiving mechanical circulatory support: a network meta-analysis

Zhang

Han

Sun

et al. 2022

BMC Cardiovasc Disord

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Objective Mechanical circulatory support (MCS) devices are widely used for cardiogenic shock (CS). This network meta-analysis aims to evaluate which MCS strategy offers advantages. Methods A systemic search of PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials was performed. Studies included double-blind, randomized controlled, and observational trials, with 30-day follow-ups. Paired independent researchers conducted the screening, data extraction, quality assessment, and consistency and heterogeneity assessment. Results We included 39 studies (1 report). No significant difference in 30-day mortality was noted between venoarterial extracorporeal membrane oxygenation (VA-ECMO) and VA-ECMO plus Impella, Impella, and medical therapy. According to the surface under the cumulative ranking curve, the optimal ranking of the interventions was surgical venting plus VA-ECMO, medical therapy, VA-ECMO plus Impella, intra-aortic balloon pump (IABP), Impella, Tandem Heart, VA-ECMO, and Impella plus IABP. Regarding in-hospital mortality and 30-day mortality, the forest plot showed low heterogeneity. The results of the node-splitting approach showed that direct and indirect comparisons had a relatively high consistency. Conclusions IABP more effectively reduce the incidence of 30-day mortality compared with VA-ECMO and Impella for the treatment of CS.

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Section: Discussionmentioning

confidence: 99%

Mortality in cardiogenic shock patients receiving mechanical circulatory support: a network meta-analysis

Zhang

Han

Sun

et al. 2022

BMC Cardiovasc Disord

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“…Options for acute MCS ( Figure 1 ) include the intra-aortic balloon pump (IABP), percutaneous ventricular assist devices (VAD) (Impella, TandemHeart), and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) [ 25 ]. The characteristics of the various devices are summarized in Table 2 [ 10 , 23 , 25 , 26 ].…”

Section: Mechanical Circulatory Supportmentioning

confidence: 99%

Mechanical Circulatory Support Devices for the Treatment of Cardiogenic Shock Complicating Acute Myocardial Infarction—A Review

Bruoha

Yosefy

Taha

et al. 2022

JCM

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Cardiogenic shock complicating acute myocardial infarction is a complex clinical condition associated with dismal prognosis. Routine early target vessel revascularization remains the most effective treatment to substantially improve outcomes, but mortality remains high. Temporary circulatory support devices have emerged with the aim to enhance cardiac unloading and improve end-organ perfusion. However, quality evidence to guide device selection, optimal installation timing, and post-implantation management are scarce, stressing the importance of multidisciplinary expert care. This review focuses on the contemporary use of short-term support devices in the setting of cardiogenic shock following acute myocardial infarction, including the common challenges associated this practice.

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Section: Introductionmentioning

confidence: 99%

“…1 CS may result in multiorgan failure requiring admission to intensive care 2 for pharmacological and often mechanical circulatory support (MCS) for cardiac output to maintain end-organ perfusion and oxygen delivery. 3 The incidence of CS complicating STEMI in the United States has been steadily increasing from 6.3% in 2003 to 10.1% in 2010. 1 Over the same period, there has been an improvement in survival, but it remains unacceptably high at 34%.…”

Section: Introductionmentioning

confidence: 99%

Right ventricular function is associated with 28-day mortality in myocardial infarction complicated by cardiogenic shock: A retrospective observational study

Lashin

Olusanya

2021

Journal of the Intensive Care Society

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Background Right ventricular (RV) function is increasingly being recognised as an important factor influencing outcomes in ST elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). In this study, we investigated RV echocardiographic parameters’ association with 28-day mortality in patients admitted to intensive care with STEMI complicated by CS with reduced left ventricle ejection fraction (LVEF). Method We performed a retrospective analysis of patients admitted to intensive care unit (ICU) in a single tertiary cardiac centre over a 34-month period with STEMI complicated by CS and LVEF < 40%. Clinical and echocardiographic data were collected and correlated with 28-day mortality. Results One-hundred patients were included with a mean age of 62.6 ±12.7 years and 78% were male. Mortality at 28 days was 37%. Respectively, 85%, 40% and 25% of patients required mechanical ventilation, mechanical circulatory support and renal replacement therapy. Tricuspid annulus peak systolic velocity (RV S’) was significantly higher in survivors (12 ± 3.3 v 10 ± 3.5 cm/s, p = 0.03) and was an independent predictor of mortality (odds ratio 1.2, 95% confidence interval 1.1–1.4, p = 0.04). RV S’ of 10.5 cm/s exhibited best sensitivity and specificity (64% and 65%, respectively; p = 0.02) for mortality. The Kaplan–Meier curve demonstrated 85% risk of 28-day mortality for RV S’ < 10.5 cm/s v 53% for RV S’ > 10.5 cm/s ( p = 0.02). Conclusion RV function is associated 28-day mortality in patients admitted to ICU with STEMI complicated by CS with reduced LVEF. RV S’ predicted mortality with good sensitivity and specificity.

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Acute Mechanical Circulatory Support for Cardiogenic Shock

Cited by 45 publications

References 41 publications

Mortality in cardiogenic shock patients receiving mechanical circulatory support: a network meta-analysis

Mortality in cardiogenic shock patients receiving mechanical circulatory support: a network meta-analysis

Mechanical Circulatory Support Devices for the Treatment of Cardiogenic Shock Complicating Acute Myocardial Infarction—A Review

Right ventricular function is associated with 28-day mortality in myocardial infarction complicated by cardiogenic shock: A retrospective observational study

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