Boudou N, Marcheix B, Biendel-Piquet C, Dumonteil N, Lhermusier T, Benhaoua H, Carrié D
Hôpital de Rangueil, CHU de Toulouse, France.
Ann Cardiol Angeiol (Paris). 2010 Dec;59(6):362-6. doi: 10.1016/j.ancard.2010.10.002. Epub 2010 Oct 20.
Cardiogenic shock is the leading cause of in-hospital death for myocardial infarction. Despite therapeutic improvements, such as medical treatment with inotropes, myocardial revascularization, circulatory assistance can be an option. Intra-aortic balloon pumping is highly recommended in the presence of haemodynamic impairment. If the patient continues to deteriorate and cardiac function cannot maintain adequate circulation to prevent end-organ failure, several mechanical circulatory assist devices can be considered: extracorporeal membrane oxygenator (ECMO), Impella(®)… These devices should be used at tertiary centres either as bridge to recovery or as bridge to transplantation or as bridge to long-term left ventricle assist device.
心源性休克是心肌梗死住院死亡的主要原因。尽管有治疗上的改进，如使用正性肌力药物进行药物治疗、心肌血运重建，但循环辅助仍可作为一种选择。在存在血流动力学损害的情况下，强烈推荐使用主动脉内球囊反搏。如果患者病情持续恶化且心脏功能无法维持足够的循环以预防终末器官衰竭，则可考虑几种机械循环辅助装置：体外膜肺氧合（ECMO）、Impella（®）……这些装置应在三级中心使用，作为恢复的桥梁、移植的桥梁或长期左心室辅助装置的桥梁。
