Intestinal Fatty Acid Binding Protein is Associated With Mortality in Patients With Acute Heart Failure or Cardiogenic Shock
Conclusion: Circulating levels of iFABP at admission predict mortality. This suggests that early inadequate perfusion of the small intestine may be associated with a dramatically decreased survival in patients with cardiogenic shock or severe acute heart failure.
Conclusions: Additional research is needed to establish new triage algorithms and to clarify intensity and timing of pharmacological and mechanical therapies.
Authors: Jha S, Zeijlon R, Shekka Espinosa A, Alkhoury J, Oras J, Omerovic E, Redfors B Abstract INTRODUCTION: Takotsubo syndrome (TS) is an increasingly recognized acute heart failure syndrome which is self-limiting in most cases but can result in life-threatening complications. TS is difficult to distinguish from acute myocardial infarction (AMI) early in the disease course and currently lacks evidence-based treatment recommendations. Areas covered: Based on the available literature this systematic review discusses the clinical management of patients with TS during (i) the diagnostic workup; (ii) acutely after es...
ConclusionHigh levels of clinical suspicion are necessary for the early detection and intervention of TCAF. Surgical or transcatheter interventions including fistula ligation and CABG can prevent later complications of heart failure.
The "ECMO for Greater Poland" program takes full advantage of the ECMO (Extracorporeal Membrane Oxygenation) perfusion therapy opportunities to promote health for 3.5 million inhabitants in the region. The main implementation areas are treatment of:patients with hypothermia;severe reversible respiratory failure (RRF);critical states resulting in heart failure i.e.: cardiac arrest; cardiogenic shock or acute intoxication;and promotion of donor after circulatory death (DCD) strategy in selected organ donor cases, after unsuccessful life saving treatment, to achieve organ recovery.
CONCLUSION: Our study suggests that PCRTO is a simple, safe and reversible alternative weaning method. It may have a particular role in the assessment of patients who have marginal recovery and right heart failure. Prospective controlled studies are needed to establish the potential role of PCRTO in the liberation of patients from VA-ECMO support. PMID: 29409389 [PubMed - as supplied by publisher]
Cardiogenic shock is well-recognized as one of the catastrophic acute heart failure syndromes especially in the setting of an acute myocardial infarction. Even in the era of early prompt coronary reperfusion with a conventional mechanical circulatory support, systemic and myocardial tissue-level mal-perfusion have a critical role in the fatal pathogenesis of a cardiogenic shock complicating acute myocardial infarction. In 2017, the Impella system has been launched in Japan for a variety of acute cardiogenic shocks.
Abstract AimsVentricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support allowing haemodynamic stabilization, followed by delayed repair. Therefore, we analysed our experience with an early use of Veno‐Arterial Extracorporeal Membrane Oxygenation (V‐A ECMO) for postinfarction VSR. Methods and resultsWe conducted a retrospective search of institutional database for patie...
ConclusionThe results of the ECMO‐CS trial may significantly influence current practice in the management of patients with severe and rapidly deteriorating cardiogenic shock. ECMO‐CS trial registration number is NCT02301819.
We report on a young multiparous woman with cardiogenic shock caused by severe PPCM who was successfully, but atypically, supported with veno-venous ECMO as a bridge to recovery immediately after the birth of her third child. PMID: 27881700 [PubMed - as supplied by publisher]
CONCLUSION:The variables that interplay in cases of severe aortic stenosis are what cause these patients to be so difficult to manage, and specific therapies targeted to fix one issue often worsen the effects of another issue. If someone is in respiratory distress, their airway and breathing needs to be secured, either through non-invasive or invasive means. Next, the patient ’s blood pressure needs to be stabilized. Oftentimes the most appropriate agent will be a positive inotrope, with consideration of a vasoactive agent in persistent hypotension. Once a patient is stabilized, determining the extent of damage to th...