Management Trends of Cardiogenic Shock Utilizing Mechanical Circulatory Support

Authors

Thomas Gauldin, University of LynchburgFollow

Specialty

Cardiothoracic Surgery/Cardiology

Advisor

Dr. Laura Witte

Abstract

ABSTRACT

Purpose: The purpose of this article is to discuss the recent changes in treatment regimens for Cardiogenic Shock (CS). CS can be induced by viral, ischemic or post-pericardiotomy ventricular failure. Historically, treatment was limited to inotropic medications or Intra-Aortic Balloon Pump (IABP) counter-pulsation. Recently, intervention is now often augmented or replaced with Ventricular Assist Devices (VAD). Clarification is needed on the mortality effects and analysis of the cost association with this new technology.

Method: A PubMed and Google Scholar literature search was conducted with search terms: shock, cardiogenic, heart-assist devices, intra-aortic balloon pumping. Sixty-seven articles were retrieved and further selected for pertinence to the review criteria.

Results: There are conflicting results in the literature as to the mortality benefits with VAD support in CS, but as the devices evolve and better patient selection criteria are utilized there is increasing evidence for their benefit. Limited evidence shows significant cost associated with these devices.

Conclusion: CS is a serious condition that carries a high rate of mortality. Advancements in treatment include the addition of VAD therapy that has expanded in recent years. The ability to initiate VAD therapy by percutaneous route has made it more accessible in the non-surgical settings such as the cardiac catheterization lab. Additional research is needed to prove the mortality benefits and support the rapid adoption of this therapy modem and the increase in costs that accompanies these newer medical devices.

Keywords: Shock, Cardiogenic, Heart-Assist Devices, Intra-Aortic Balloon Pump.

Recommended Citation

Gauldin T. Management Trends of Cardiogenic Shock Utilizing Mechanical Circulatory Support. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2020; 2(4).