This paper of Andrea Montisci, MD, et al. discusses the latest guidance for identifying patients with cardiogenic shock (CS) who are candidates for mechanical circulatory support (MCS).
Letizia Bertoldi, MD, and colleagues describe how catecholamines and percutaneous ventricular assist devices (pVADs) are used to treat cardiogenic shock (CS). Bertoldi et al. propose an algorithm for practical management of inotropes in CS as well as an algorithm for selection of pVADs in patients with CS.
Prof. Giuseppe Tarantini, MD, and colleagues describe a “4 early step” approach for timely management of patients with acute myocardial infarction cardiogenic shock (AMICS).
Mechanical Circulatory Support in Cardiogenic Shock
For patients with cardiogenic shock (CS) supported with percutaneous ventricular assist devices (pVADs) in the ICU, Prof. Christophe Vandenbriele, MD, et al. assert that haemodynamic monitoring tools and echocardiography constitute the cornerstone of monitoring, complemented by numerous biochemical tests to optimize the management of these patients.
“The decision to escalate, de-escalate or wean is highly dependent on patient presentation, capabilities of the institution, and the expertise of the heart team,” write PD Alexander M. Bernhardt, MD, et al. of their paper on differential usage of Impella® heart pump devices, extracorporeal membrane oxygenation (ECMO) and combined strategies in patients with cardiogenic shock.
This article of Benedikt Schrage, MD, et al. describes escalation and weaning best practices for patients with cardiogenic shock supported with ECMELLA—a combination of Impella and extracorporeal membrane oxygenation (ECMO). The authors identify specific clinical scenarios in which escalation to ECMELLA should be considered and describe the concept of protected weaning for ECMELLA patients.
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