Management of Peripheral Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock

Conclusions: Extracorporeal membrane oxygenation is a powerful mechanical circulatory support modality capable of rapidly restoring systemic perfusion yet lacking in defined approaches to management. Adopting a management approach based physiologic principles provides a basis for care.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research

Related Links:

CARDIOGENIC SHOCK is a state of inadequate end-organ perfusion resulting from myriad causes, including ischemia, myocarditis, acute and chronic heart failure, postcardiotomy, and post-transplantation. It is the leading cause of death among patients experiencing acute myocardial infarction, with a mortality of 40% to 50%.1 Treatment generally includes revascularization for ischemia and supportive care with inotropes, vasopressors, and fluids as needed. Refractory cardiogenic shock is defined as ongoing hypoperfusion despite the administration of multiple vasoactive medications and treatment of the underlying cause.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research
ConclusionsEmergency ECLS is a valuable option among patients with AMI-induced CS with low and intermediate IABP SHOCK II risk scores. ECLS weaning is manageable but additional revascularization of all non-culprit lesions is mandatory after ECLS implementation.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSIONS: Emergency ECLS is a valuable option among patients with AMI-induced CS with low and intermediate IABP SHOCK II risk scores. ECLS weaning is manageable but additional revascularization of all non-culprit lesions is mandatory after ECLS implementation. PMID: 31175870 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
ConclusionRight SCA with congenital absence of the LCA is one of the rarest coronary artery anomalies. In a significant percentage of patients it is associated with ischemia and can be life-threatening. CCTA and MRI are the modalities of choice for diagnosis and risk stratification.ResumoIntroduçãoArtéria coronária única (ACU) sem cardiopatia congénita associada é uma entidade rara. Maioria dos casos é assintomática e achados acidentais, mas podem causar isquémia, insuficiência cardíaca congestiva e morte súbita (MS).Caso clíni...
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
CONCLUSION: Mode-switch from veno-arterial to veno-veno-arterial and weaning via veno-venous extracorporeal membrane oxygenation mode is feasible for combined cardiac and pulmonary failure, with promising results due to an optimized pre-pulmonary oxygenation. PMID: 31081459 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
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.
Source: Shock - Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research
Conclusions: Additional research is needed to establish new triage algorithms and to clarify intensity and timing of pharmacological and mechanical therapies.
Source: American Journal of Therapeutics - Category: Drugs & Pharmacology Tags: Systematic Reviews Source Type: research
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...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
Abstract Temporary mechanical cardiac support (TMCS) devices intend to restore systemic perfusion and prevent further end-organ damage in patients with refractory cardiogenic shock until the insult is addressed. TMCS has been associated with reductions in hospital costs and in-hospital mortality. We review the four primary TMCS modalities available: intra-aortic balloon pump, TandemHeart, veno-arterial extracorporeal membrane oxygenation, and Impella pump. All have their own implantation technique and hemodynamic profile, and their use may therefore be tailored to the specific patient's needs. The appropriate TMCS...
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research
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.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
More News: Cardiogenic Shock | Cardiology | Emergency Medicine | Heart | Heart Failure | Perfusion | Study