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Unloading in cardiogenic shock: the rationale and current evidence

Abstract Purpose of review  Discussing the rationale and current evidence for left ventricular unloading in cardiogenic shock. Recent findings  Microaxial flow pumps (MFP) and intra-aortic balloon pumps (IABP) augment cardiac..

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Design and principle of operation of the HeartMate PHP (percutaneous heart pump)

Abstract The HeartMate PHP (percutaneous heart pump) is a second-generation transcatheter axial flow circulatory support system. The collapsible catheter pump is inserted through a 14 Fr sheath, deployed across the..

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Routine venoarterial extracorporeal membrane oxygenation for acute myocardial infarction-related cardiogenic shock: what we know and don’t know

Abstract Acute myocardial infarction-related cardiogenic shock (AMI-CS) carries a dismal prognosis. Short-term mortality is in the range of 40–50% []. Until recently, only treatment of the culprit lesion by percutaneous..

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Step by step daily management of short-term mechanical circulatory support for cardiogenic shock in adults in the intensive cardiac care…

Abstract The use of mechanical circulatory support using percutaneous ventricular assist devices (pVAD) has increased rapidly during the last decade without substantial new evidence for their effect on outcome. In..

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Joint EAPCI/ACVC expert consensus document on percutaneous ventricular assist devices

Abstract There has been a significant increase in the use of short-term percutaneous ventricular assist devices (pVADs) as acute circulatory support in cardiogenic shock and to provide haemodynamic support during..

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Features and outcomes of female and male patients requiring postcardiotomy extracorporeal life support

Abstract Objectives Although cardiogenic shock requiring extracorporeal life support after cardiac surgery is associated with high mortality, the impact of sex on outcomes of postcardiotomy extracorporeal life support remains unclear..

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Sex differences in treatments and outcomes of patients with cardiogenic shock: a systematic review and epidemiological meta-analysis

Abstract Background Women are at higher risk of mortality from many acute cardiovascular conditions, but studies have demonstrated differing findings regarding the mortality of cardiogenic shock in women and men...

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Criteria for Defining Stages of Cardiogenic Shock Severity

Abstract Background Risk-stratifying patients with  (CS) is a major unmet need. The recently proposed Society for Cardiovascular  and Interventions (SCAI) staging system for CS severity lacks uniform criteria defining each stage. Objectives..

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Comparing Outcomes of Post-Cardiotomy Cardiogenic Shock Patients: On-Site Cannulation vs. Retrieval for V-A ECMO Support

Abstract Background:    Post-cardiotomy cardiogenic shock (PCCS) remains a life-threatening complication after cardiac surgery. Extracorporeal membrane oxygenation (ECMO) represents the mainstay of mechanical circulatory support for PCCS; however, its availability..

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Venoarterial extracorporeal membrane oxygenation in immunocompromised patients with cardiogenic shock: a cohort study and propensity-weighted analysis

Abstract Purpose: The outcomes of immunocompromised patients with cardiogenic shock treated with venoarterial extra‑corporeal membrane oxygenation (VA‑ECMO) are seldom documented, making ECMO candidacy decisions challeng‑ing. This study aims (1) to..

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Critical insights into venoarterial extracorporeal membrane oxygenation outcomes in immunocompromised patients: addressing uncertainties in cause of death and treatment strategies

Abstract In a recent issue of Intensive Care Medicine, we read with great interest the article by Moyon et al. [1] who retro-spectively studied the outcomes of immunocompromised patients with..

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Protected cardiac surgery: strategic mechanical circulatory support to improve postcardiotomy mortality

Abstract Purpose of review  To examine the evolving landscape of cardiac surgery, focusing on the increasing complexity of patients and the role of mechanical circulatory support (MCS) in managing perioperative..

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Validation of predictive models for 90-day survival in immunocompromised patients with cardiogenic shock on venoarterial extracorporeal membrane oxygenation

Abstract Predictive survival models have been proposed to esti-mate survival rates in patients with refractory cardio-genic shock considered for veno-arterial extracorporeal membrane oxygenation (VA-ECMO) [1, 2]. Notably, the Survival after..

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Why left atrial venting fails to influence extracorporeal life support survival in cardiogenic shock: Unravelling the intricate reality of unloading

Abstract Over the past decade, extracorporeal life support (ECLS) has gained increasing utilization in the management of refractory cardiogenic shock (CS) with a class IIaC recommendation according to the latest..

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Routine venoarterial extracorporeal membrane oxygenation for acute myocardial infarction‑related cardiogenic shock: what we know and don’t know

Abstract Acute myocardial infarction-related cardiogenic shock (AMI-CS) carries a dismal prognosis. Short-term mortality is in the range of 40–50% [1]. Until recently, only treatment of the culprit lesion by percutaneous..

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Beyond one-size-fits-all in cardiogenic shock: impella, extracorporeal membrane oxygenation or tailored use of mechanical circulatory support?

Abstract Purpose of review  This article offers an overview of recent randomized controlled trials (RCTs) testing the efficacy of veno-arterial extracorporeal membrane oxygenation (VA ECMO) and microaxial flow pump (mAFP)..

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Mechanical circulatory support in cardiogenic shock: microaxial flow pumps for all and VA‑ECMO consigned to the museum?

Abstract Introduction Mortality rates in cardiogenic shock remain high, especially in patients with SCAI shock stages C to E [1].When hemodynamic status does not improve or worsens despite optimal fluid,..

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Intra-aortic balloon pump in patients undergoing VA-ECMO: an analysis of the Chinese Extracorporeal Life Support Registry

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used to treat refractory cardiogenic shock (CS) or cardiac arrest (CA) over the past decades. Peripheral VA-ECMO increases left ventricular (LV)..

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Extra-Corporeal Membrane Oxygenation in Pregnancy

Abstract Extracorporeal membrane oxygenation (ECMO) is a cardiac or pulmonary function support system that is used in cases of refractory organ failure in addition to conventional treatment. Currently, Level I..

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Features and Outcomes of Females and Males Requiring Postcardiotomy Extracorporeal Life Support

Abstract Background Although cardiogenic shock requiring extracorporeal life support (ECLS) after cardiac surgery is associated with high mortality, the impact of sex on outcomes of post-cardiotomy ECLS remains unclear with..

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VA-ECMO weaning strategy using adjusted pulse pressure by vasoactive inotropic score in AMI complicated by cardiogenic shock

Abstract Aims This study evaluated how well serial pulse pressure (PP) and PP adjusted by the vasoactive inotropic score (VIS) predicted venoarterial extracorporeal membrane oxygenation (VA-ECMO) weaning success and clinical..

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Hypothermia in patients with cardiac arrest prior to ECMO-VA: Insight from the HYPO-ECMO trial

Abstract Aim Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has become a common intervention for patients with cardiogenic shock (CS), often complicated by cardiac arrest (CA). Moderate hypothermia (MH) has shown promise..

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Extracorporeal Membrane Oxygenation for Septic Shock in Adults and Children: A Narrative Review

Abstract Refractory septic shock is associated with a high risk of death. Circulatory support in the form of veno-arterial extracorporeal membrane oxygenation (VA ECMO) may function as a bridge to..

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Cardiogenic shock in 2024: insight the complex reality of ECLS and left ventricular unloading strategies

Abstract Despite immediate coronary revascularization, mortality of patients experiencing infarct-related cardiogenic shock (AMICS) remains high [1]. Over the past decade, there has been a growing interest in the use of..

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Cardiac ECMO: changing role in times of Impella and ventricular assist devices?

Abstract Mortality in infarct-related as well as heart failure-associated cardiogenic shock remains high, reaching 40–50% depending on the etiology and severity of cardiogenic shock. Percutaneous active mechanical circulatory support devices..

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What the pediatric nurse needs to know about the Impella cardiac assist device

Abstract Background: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients..

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Clinical decision making for VA ECMO weaning in patients with cardiogenic shock A formative qualitative study

Abstract Weaning and liberation from VA ECMO in cardiogenic shock patients comprises a complex process requiring a continuous trade off between multiple clinical parameters. In the absence of dedicated international..

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How to manage differential hypoxemia during veno-arterial extracorporeal membrane oxygenation

Abstract Over the past decade, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has expanded rapidly as a salvage strategy to provide temporary circulatory and respiratory support allowing cardiac function recovery or bridging..

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ECMO Alone Versus ECPELLA in Patients Affected by Cardiogenic Shock: The Multicenter EVACS Study

Abstract The objective was to investigate the outcomes of concomitant venoarterial extracorporeal membrane oxygenation (ECMO) and left ventricular unloading with Impella (ECPELLA) compared with ECMO alone to treat patients affected..

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The physiology of venoarterial extracorporeal membrane oxygenation - A comprehensive clinical perspective

Abstract Venoarterial extracorporeal membrane oxygenation (VA ECMO) has become a standard of care for severe cardiogenic shock, refractory cardiac arrest and related impending multiorgan failure. The widespread clinical use of..

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