Monitoring MCS patients on the intensive care unit: integrating haemodynamic assessment, laboratory data, and imaging techniques for timely detection of deterioration and recovery.

IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS European Heart Journal Supplements Pub Date : 2023-12-13 eCollection Date: 2023-12-01 DOI:10.1093/eurheartjsupp/suad130
Christophe Vandenbriele, Luca Baldetti, Alessandro Beneduce, Jan Belohlavek, Christian Hassager, Marina Pieri, Amin Polzin, Anna Mara Scandroglio, Jacob Eifer Møller
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Abstract

Monitoring of the patient supported with a temporary mechanical circulatory support (tMCS) is crucial in achieving the best possible outcome. Monitoring is a continuous and labour-intensive process, as cardiogenic shock (CS) patients can rapidly deteriorate and may require new interventions within a short time period. Echocardiography and invasive haemodynamic monitoring form the cornerstone of successful tMCS support. During monitoring, it is particularly important to ensure that adequate end-organ perfusion is achieved and maintained. Here, we provide a comprehensive overview of best practices for monitoring the CS patient supported by a micro-axial flow pump, veno-arterial extracorporeal membrane oxygenation, and both devices simultaneously (ECMELLA approach). It is a complex process that encompasses device control, haemodynamic control and stabilization, monitoring of interventions, and assessment of end-organ function. The combined, continuous, and preferably protocol-based approach of echocardiography, evaluation of biomarkers, end-organ assessment, and haemodynamic parameters is crucial in assessing this critically ill CS patient population.

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监测重症监护室中的多发性硬化症患者:整合血液动力学评估、实验室数据和成像技术,及时发现病情恶化和恢复情况。
对使用临时机械循环支持系统(tMCS)的患者进行监护,对于实现最佳治疗效果至关重要。由于心源性休克(CS)患者的病情会迅速恶化,可能需要在短时间内采取新的干预措施,因此监测是一个持续且劳动密集型的过程。超声心动图和有创血流动力学监测是成功的 tMCS 支持的基石。在监测过程中,确保实现并维持足够的终末器官灌注尤为重要。在此,我们全面概述了对由微轴流泵、静脉-动脉体外膜氧合以及两种设备同时支持的 CS 患者进行监测的最佳实践(ECMELLA 方法)。这是一个复杂的过程,包括设备控制、血流动力学控制和稳定、干预监测和末梢器官功能评估。超声心动图、生物标志物评估、内脏器官评估和血流动力学参数的综合、连续和基于方案的方法对于评估 CS 重症患者至关重要。
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来源期刊
European Heart Journal Supplements
European Heart Journal Supplements 医学-心血管系统
CiteScore
3.00
自引率
0.00%
发文量
575
审稿时长
12 months
期刊介绍: The European Heart Journal Supplements (EHJs) is a long standing member of the ESC Journal Family that serves as a publication medium for supplemental issues of the flagship European Heart Journal. Traditionally EHJs published a broad range of articles from symposia to special issues on specific topics of interest. The Editor-in-Chief, Professor Roberto Ferrari, together with his team of eminent Associate Editors: Professor Francisco Fernández-Avilés, Professors Jeroen Bax, Michael Böhm, Frank Ruschitzka, and Thomas Lüscher from the European Heart Journal, has implemented a change of focus for the journal. This entirely refreshed version of the European Heart Journal Supplements now bears the subtitle the Heart of the Matter to give recognition to the focus the journal now has. The EHJs – the Heart of the Matter intends to offer a dedicated, scientific space for the ESC, Institutions, National and Affiliate Societies, Associations, Working Groups and Councils to disseminate their important successes globally.
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