Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy.
Blood Purif. 2013;35(1-3):119-26. doi: 10.1159/000346096. Epub 2013 Jan 22.
Ventricular assist devices (VADs) are used to improve the systemic circulation and to decrease ventricular loading in patients with hemodynamic instability that is refractory to pharmacologic therapies. During an acute critical event, percutaneous devices are preferred because of their rapid deployment, since implantable devices require more extensive procedures. Implantable devices are used for patients with established end-stage heart failure as a bridge to heart transplantation, recovery or destination therapy. This report reviews mechanical principles and clinical studies regarding percutaneous VAD to address their potential renal effects. Since the focus of this study is set on devices that are dedicated to cardiac support only, extracorporeal membrane oxygenation systems are not included.
心室辅助装置(VAD)用于改善血液动力学不稳定且对药物治疗无反应的患者的全身循环并降低心室负荷。在急性危急情况下,由于其快速部署,因此更倾向于使用经皮装置,因为植入式装置需要更广泛的程序。植入式装置用于已患有终末期心力衰竭的患者,作为心脏移植、恢复或靶心治疗的桥梁。本报告回顾了有关经皮 VAD 的机械原理和临床研究,以探讨其对肾脏的潜在影响。由于本研究的重点仅放在专门用于心脏支持的设备上,因此不包括体外膜氧合系统。