PMID- 29901460
OWN - NLM
STAT- MEDLINE
DCOM- 20190617
LR  - 20190617
IS  - 1531-7072 (Electronic)
IS  - 1070-5295 (Linking)
VI  - 24
IP  - 4
DP  - 2018 Aug
TI  - Mechanical circulatory devices in acute heart failure.
PG  - 286-291
LID - 10.1097/MCC.0000000000000520 [doi]
AB  - PURPOSE OF REVIEW: Temporary circulatory support (TCS) with short-term mechanical 
      circulatory support (MCS) devices is increasingly used as a salvage therapy for 
      patients with refractory cardiogenic shock. This article provides an overview of 
      current devices, their indications and management, and discusses results of 
      recent case series and trials. RECENT FINDINGS: Percutaneous active MCS devices 
      (Impella, TandemHeart...) and venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO) are utilized as a bridge to 'decision' that includes weaning after 
      cardiac function recovery, transplantation, long-term MCS and withdrawal in case 
      of futility. VA-ECMO is considered the first-line TCS since it allows rapid 
      improvement in oxygenation, is less expensive, and is also suitable for patients 
      with biventricular failure. Combining Impella or intra-aortic balloon pump 
      support with ECMO might decrease left ventricular pressure and improve outcomes. 
      Sepsis-associated cardiomyopathy, massive pulmonary embolism, arrhythmic storm 
      and Takotsubo-like cardiomyopathy are among emerging indications for TCS. 
      SUMMARY: TCS have become the cornerstone of the management of patients with 
      cardiogenic shock, although the evidence supporting their efficacy is limited. 
      VA-ECMO is considered the first-line option, with a growing number of accepted 
      and emerging indications. Randomized clinical trials are now needed to determine 
      the respective place of different MCS devices in cardiogenic shock treatment 
      strategies.
FAU - Pineton de Chambrun, Marc
AU  - Pineton de Chambrun M
AD  - Service de Medecine Intensive-Reanimation, Institut de Cardiologie, APHP Hopital 
      Pitie-Salpetriere.
AD  - Sorbonne Universite, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and 
      Nutrition, Paris, France.
FAU - Brechot, Nicolas
AU  - Brechot N
AD  - Service de Medecine Intensive-Reanimation, Institut de Cardiologie, APHP Hopital 
      Pitie-Salpetriere.
AD  - Sorbonne Universite, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and 
      Nutrition, Paris, France.
FAU - Combes, Alain
AU  - Combes A
AD  - Service de Medecine Intensive-Reanimation, Institut de Cardiologie, APHP Hopital 
      Pitie-Salpetriere.
AD  - Sorbonne Universite, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and 
      Nutrition, Paris, France.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Crit Care
JT  - Current opinion in critical care
JID - 9504454
SB  - IM
MH  - Assisted Circulation/*methods
MH  - *Critical Care
MH  - Extracorporeal Membrane Oxygenation
MH  - Health Services Needs and Demand
MH  - Heart Failure/physiopathology/*therapy
MH  - Humans
MH  - Intra-Aortic Balloon Pumping
MH  - Practice Guidelines as Topic
MH  - Randomized Controlled Trials as Topic
MH  - Shock, Cardiogenic/physiopathology/*therapy
MH  - Time Factors
EDAT- 2018/06/15 06:00
MHDA- 2019/06/18 06:00
CRDT- 2018/06/15 06:00
PHST- 2018/06/15 06:00 [pubmed]
PHST- 2019/06/18 06:00 [medline]
PHST- 2018/06/15 06:00 [entrez]
AID - 10.1097/MCC.0000000000000520 [doi]
PST - ppublish
SO  - Curr Opin Crit Care. 2018 Aug;24(4):286-291. doi: 10.1097/MCC.0000000000000520.