Management of temporary mechanical circulatory support devices in cath-lab and cardiac intensive care unit

Federico Fortuni, Filippo Zilio, Gianmarco Iannopollo, Giuseppe Ciliberti, Paolo Trambaiolo, Laura Ceriello, Francesca Musella, Pietro Scicchitano, Stefano Albani, Stefania Angela Di Fusco, Michele Massimo Gulizia, Domenico Gabrielli, Fabrizio Oliva, Furio Colivicchi
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Abstract

Abstract Different temporary mechanical circulatory support (tMCS) devices are available and can be used to maintain end-organ perfusion while reducing cardiac work and myocardial oxygen demand. tMCS can provide support to the right ventricle, left ventricle, or both, and its use can be considered in emergency situations such as cardiogenic shock or in elective procedures such as high-risk percutaneous coronary intervention to prevent haemodynamic deterioration. Invasive and, most importantly, non-invasive haemodynamic parameters should be taken into account when choosing the type of tMCS device and its initiation and weaning timing, determining the need for a device upgrade, and screening for complications. In this context, ultrasound tools, specifically echocardiography, can provide important data. This review aims to provide a description of the different tMCS devices, the invasive and non-invasive tools and parameters to guide their management, and their advantages and drawbacks.
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导管室和心脏重症监护病房临时机械循环支持装置的管理
临时机械循环支持(tMCS)装置可用于维持终末器官灌注,同时减少心脏功和心肌需氧量。tMCS可以为右心室、左心室或两者提供支持,可以考虑在紧急情况下(如心源性休克)或选择性手术(如高风险经皮冠状动脉介入治疗)中使用,以防止血流动力学恶化。在选择tMCS设备的类型及其启动和脱机时间、确定设备升级的需要以及筛查并发症时,应考虑有创性和最重要的非创性血流动力学参数。在这种情况下,超声工具,特别是超声心动图,可以提供重要的数据。本文旨在介绍不同的tMCS设备,侵入性和非侵入性的工具和参数来指导其管理,以及它们的优缺点。
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