Department of Neurology, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Division of Cardiac Surgery, Johns Hopkins University, Baltimore, MD, USA.
Curr Neurol Neurosci Rep. 2021 Mar 10;21(5):20. doi: 10.1007/s11910-021-01107-0.
Mechanical circulatory support (MCS) devices have demonstrated improved survival outcomes in otherwise refractory cardiopulmonary failure but are associated with significant neurologic morbidity and mortality. This review aims to characterize MCS-associated brain injury and discuss the neurocritical care of this population.
We found no practice guidelines or specific management strategies for the neurocritical care of patients with MCS devices. Acute brain injury was commonly observed in short-term and durable MCS devices. There is emerging evidence that a standardized neurological monitoring and management algorithm for MCS device-associated brain injury is feasible and potentially improves neurological outcomes. While MCS devices are associated with significant neurologic morbidity and mortality, there is scant evidence regarding optimal neuromonitoring and neurocritical care. With the increase in use of MCS devices for both short-term and durable applications, improved outcomes will depend on early identification and intervention of neurologic complications and further research into their pathophysiology.
机械循环支持（MCS）设备在心肺衰竭的情况下提高了生存率，但与显著的神经发病率和死亡率相关。本综述旨在描述 MCS 相关的脑损伤，并讨论该人群的神经危重症护理。
我们没有发现针对 MCS 设备患者神经危重症护理的实践指南或特定管理策略。在短期和持久的 MCS 设备中，急性脑损伤很常见。有证据表明，针对 MCS 设备相关脑损伤的标准化神经监测和管理算法是可行的，并且可能改善神经结局。虽然 MCS 设备与显著的神经发病率和死亡率相关，但关于最佳神经监测和神经危重症护理的证据很少。随着 MCS 设备在短期和持久应用中的使用增加，改善结果将取决于早期识别和干预神经并发症，并进一步研究其病理生理学。
