Mechanical Circulatory Support in Acute Decompensated Heart Failure and Shock

Sodhi, Nishtha; Lasala, John M.

doi:10.1016/j.iccl.2017.03.008

Cited by 10 publications

(29 citation statements)

References 33 publications

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“…The gas lumen serves as the conduit for the rapid exchange of helium in and out of the balloon. 30) The proper position of the distal tip is 1-2 cm distal to the left subclavian artery (the second to third intercostal space or 2 cm above the carina). 31) Balloon obstruction of the left subclavian artery and visceral arteries, such as the superior mesenteric artery and renal arteries, should be avoided, and balloon positioning should be performed under fluoroscopy to avoid these potential complications.…”

Section: Components and Catheterizationmentioning

confidence: 99%

“…30) B. Suction alarm: Suction may occur with the Impella device due to improper positioning or inadequate LV volume, and the presence of suction may lead to hemolysis. 30) The Impella position should always be confirmed with imaging, and adjustments should be made to space the inlet from the ventricular wall. The device relies on a functional RV to provide LV filling.…”

Section: Managementmentioning

confidence: 99%

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Mechanical Circulatory Support for Acute Heart Failure Complicated by Cardiogenic Shock

2020

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Acute heart failure is a potentially life-threatening condition that can lead to cardiogenic shock, which is associated with hypotension and organ failure. Although there have been many studies on the treatment for cardiogenic shock, early mortality remains high at 40-50%. No new medicines for cardiogenic shock have been developed. Recently, there has been a gradual decline in the use of the intra-aortic balloon pump mainly due to a lack of adequate hemodynamic support. Extracorporeal membrane oxygenation and the percutaneous ventricular assist device have become more widely used in recent years. A thorough understanding of the mechanisms of such mechanical support devices and their hemodynamic effects, components of the devices, implantation technique, management, criteria for indications or contraindications of use, and clinical outcomes as well as multidisciplinary decision making may improve the outcomes in patients experiencing cardiogenic shock.

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Section: Components and Catheterizationmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Mechanical Circulatory Support for Acute Heart Failure Complicated by Cardiogenic Shock

2020

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“…There are approximately 6 million adults in the United States with congestive heart failure. 106 The need for percutaneous ventricular assist devices (VAD) in acute decompensated heart failure has emerged with increased survival from myocardial infarction (MI) and heart failure. Timing of circulatory support is critical for improvements in survival.…”

Section: Temporary Mechanical Circulatory Support In Systolic Heart Failurementioning

confidence: 99%

Medical management of decompensated heart failure in adult patients: Part 2: Organ involvement, invasive hemodynamic monitoring, device therapy, and outcomes

Mantilla¹,

Paz²,

Rahman³

et al. 2020

The Chronicles

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Acute decompensated heart failure is a clinical syndrome involving the congestion of vital organs, such as the kidneys, liver, and brain, leading to loss of autoregulation and multiorgan failure. The interaction between organ systems is bi-directional and complex; it cannot be explained by hypoperfusion alone. Despite the multiple signs and symptoms that arise with systemic congestion, there are limitations in the assessment of volume status based only on clinical evaluation. Invasive hemodynamic monitoring is an adjunctive diagnostic and prognostic tool in acute decompensated heart failure when standard therapy fails and/or leads to worsening renal function as well as for the evaluation of advanced therapy options. This review will discuss the use of temporary mechanical circulatory support devices in cardiogenic shock and the expected outcomes for advanced heart failure with the implementation of left ventricular assist devices and cardiac transplantation.

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“…[24][25][26] For this purpose, new devices have been developed with the aim of providing increased mechanical circulatory support and improved survival in case of refractory CS. [27][28][29][30] The most frequently used devices in clinical settings are the intra-aortic balloon pump (IABP), veno-arterial extracorporeal membrane oxygenation (ECMO), and left ventricular assist devices (LVAD). IABP, a device inserted in the aorta during an interventional procedure, consists in an intra-aortic balloon which inflates during diastole and deflates during systole, being able to decrease ventricular workload and to increase cardiac output.…”

Section: Reperfusion In Csmentioning

confidence: 99%

A Long-Forgotten Tale: The Management of Cardiogenic Shock in Acute Myocardial Infarction

Iancu

Dregoesc

Solomoneanu

et al. 2018

Journal of Cardiovascular Emergencies

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Patients with acute myocardial infarction (AMI) complicated with cardiogenic shock (CS) present one of the highest mortality rates recorded in critical care. Mortality rate in this setting is reported around 45-50% even in the most experienced and well-equipped medical centers. The continuous development of ST-segment elevation acute myocardial infarction (STEMI) networks has led not only to a dramatic decrease in STEMI-related mortality, but also to an increase in the frequency of severely complicated cases who survive to be transferred to tertiary centers for life-saving treatments. The reduced effectiveness of vasoactive drugs on a severely altered hemodynamic status led to the development of new devices dedicated to advanced cardiac support. What’s more, efforts are being made to reduce time from first medical contact to initiation of mechanical support in this particular clinical context. This review aims to summarize the most recent advances in mechanical support devices, in the setting of CS-complicated AMI. At the same time, the review presents several modern concepts in the organization of complex CS centers. These specialized hubs could improve survival in this critical condition.

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Mechanical Circulatory Support in Acute Decompensated Heart Failure and Shock

Cited by 10 publications

References 33 publications

Mechanical Circulatory Support for Acute Heart Failure Complicated by Cardiogenic Shock

Mechanical Circulatory Support for Acute Heart Failure Complicated by Cardiogenic Shock

Medical management of decompensated heart failure in adult patients: Part 2: Organ involvement, invasive hemodynamic monitoring, device therapy, and outcomes

A Long-Forgotten Tale: The Management of Cardiogenic Shock in Acute Myocardial Infarction

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