Division of Cardiology, Duke University Medical Center, Duke Clinical Research Institute, 200 Morris Street, Durham, NC 27710, USA.
Division of Cardiology, Duke University Medical Center, Duke Clinical Research Institute, 200 Morris Street, Durham, NC 27710, USA.
Cardiol Clin. 2020 Nov;38(4):527-542. doi: 10.1016/j.ccl.2020.06.006.
Cardiogenic shock (CS) is a complex condition with a high risk for morbidity and mortality. Mechanical circulatory support (MCS) devices were developed to support patients with CS in cases refractory to treatment with vasoactive medications. Current devices include intra-aortic balloon pumps, intravascular microaxial pumps, percutaneous LVAD, percutaneous RVAD, and VA ECMO. Data from limited observational studies and clinical trials show a clear difference in the level of hemodynamic support offered by each device. However, at this point, there are insufficient clinical trial data to guide MCS selection and, until ongoing clinical trials are completed, use of the right device for the right patient depends largely on clinical judgment.
心原性休克(CS)是一种复杂的病症,具有很高的发病率和死亡率。机械循环支持(MCS)设备的开发是为了在对血管活性药物治疗有反应的情况下支持 CS 患者。目前的设备包括主动脉内球囊泵、血管内微型轴流泵、经皮左心室辅助装置、经皮右心室辅助装置和 VA ECMO。来自有限的观察性研究和临床试验的数据表明,每种设备提供的血流动力学支持水平存在明显差异。然而,目前还没有足够的临床试验数据来指导 MCS 的选择,并且在正在进行的临床试验完成之前,正确的设备用于正确的患者在很大程度上取决于临床判断。