Application of mechanical circulation support devices in cardiogenic shock

doi:10.3877/cma.j.issn.2096-1537.2020.02.009

Abstract

Abstract:

Cardiogenic shock remains a disease with high mortality that requires early diagnosis and multidisciplinary intervention. The application of mechanical circulation support devices can interrupt the progression of cardiogenic shock, but the appropriate timing, equipment selection, and management are still under debate. This review will outline the application of mechanical circulatory support devices in patients with cardiogenic shock.

Key words: shock, cardiogenic, Mechanical circulation support, Intra-aortic balloon pump, Extracorporeal membrane oxygenation

Kai Liu, Ying Su, Guowei Tu, Zhe Luo. Application of mechanical circulation support devices in cardiogenic shock[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(02): 151-155.

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References 41

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设备	IABP	V-A ECMO	TandemHeart	Impella 2.5	Impella CP	Impella 5.0	Impella RP
辅助原理	气动泵	离心泵	轴流泵	轴流泵	轴流泵	轴流泵	轴流泵
插管选择	8 Fr	18~21Fr引流<break/> 15~22Fr回输	21 Fr引流<break/>15~17Fr回输	13 Fr	14 Fr	23 Fr	9 Fr
置入方式	经皮、经股动脉至降主动脉	经皮或外科，最常用股动静脉	经皮，引流管经股静脉到左心房，回输管经股动脉	经皮、经股动脉逆向跨主动脉瓣	经皮、经股动脉逆向跨主动脉瓣	外科切开，经锁骨下动脉逆向跨主动脉瓣	经皮、经股静脉顺向至跨肺动脉瓣
置入耗时	＋	＋＋＋	＋＋＋＋	＋＋	＋＋	＋＋	＋＋
支持时间	7~10 d	3~4周	2~3周	7~10 d	7~10 d	2~3周	7~10 d
支持流量	0.5~1.0 L/min	3~7 L/min	4 L/min	1.5~2 L/min	2.5~3.5 L/min	4.5~5 L/min	2.5 L/min
平均动脉压	＋	＋＋	＋＋	＋＋	＋＋	＋＋	＋＋
左心室后负荷	降低	升高	升高	不影响	不影响	不影响	不影响
左心室舒张末容积	减小	增加	减小	减少	减少	减少	不影响或增加
心脏	仅左心室	双心室	双心室	仅左心室	仅左心室	仅左心室	仅右心室
抗凝	＋	＋＋	＋＋＋	＋＋	＋＋	＋＋	＋＋
肢体缺血	＋	＋＋＋	＋＋＋	＋	＋＋	＋＋	＋/—
溶血	＋	＋＋	＋＋	＋＋	＋＋	＋＋	＋＋
出血	＋	＋＋＋	＋＋＋	＋＋	＋＋	＋＋	＋

设备	IABP	V-A ECMO	TandemHeart	Impella 2.5	Impella CP	Impella 5.0	Impella RP
辅助原理	气动泵	离心泵	轴流泵	轴流泵	轴流泵	轴流泵	轴流泵
插管选择	8 Fr	18~21Fr引流<break/> 15~22Fr回输	21 Fr引流<break/>15~17Fr回输	13 Fr	14 Fr	23 Fr	9 Fr
置入方式	经皮、经股动脉至降主动脉	经皮或外科，最常用股动静脉	经皮，引流管经股静脉到左心房，回输管经股动脉	经皮、经股动脉逆向跨主动脉瓣	经皮、经股动脉逆向跨主动脉瓣	外科切开，经锁骨下动脉逆向跨主动脉瓣	经皮、经股静脉顺向至跨肺动脉瓣
置入耗时	＋	＋＋＋	＋＋＋＋	＋＋	＋＋	＋＋	＋＋
支持时间	7~10 d	3~4周	2~3周	7~10 d	7~10 d	2~3周	7~10 d
支持流量	0.5~1.0 L/min	3~7 L/min	4 L/min	1.5~2 L/min	2.5~3.5 L/min	4.5~5 L/min	2.5 L/min
平均动脉压	＋	＋＋	＋＋	＋＋	＋＋	＋＋	＋＋
左心室后负荷	降低	升高	升高	不影响	不影响	不影响	不影响
左心室舒张末容积	减小	增加	减小	减少	减少	减少	不影响或增加
心脏	仅左心室	双心室	双心室	仅左心室	仅左心室	仅左心室	仅右心室
抗凝	＋	＋＋	＋＋＋	＋＋	＋＋	＋＋	＋＋
肢体缺血	＋	＋＋＋	＋＋＋	＋	＋＋	＋＋	＋/—
溶血	＋	＋＋	＋＋	＋＋	＋＋	＋＋	＋＋
出血	＋	＋＋＋	＋＋＋	＋＋	＋＋	＋＋	＋

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