在急性右心室衰竭中采用临时机械循环支持的实用方法。

IF 6.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Heart and Lung Transplantation Pub Date : 2024-07-24 DOI:10.1016/j.healun.2024.07.006

Anthony P. Carnicelli MD (Assistant Professor of Medicine/Cardiology) , Sean van Diepen MD , Ann Gage MD , Alexander M. Bernhardt MD , Jennifer Cowger MD , Brian A. Houston MD , Matt T. Siuba DO , Rachna Kataria MD , Craig J. Beavers PharmD , Kevin J. John MD , Bart Meyns MD PhD , Navin K. Kapur MD , Ryan J. Tedford MD , Manreet Kanwar MD

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引用次数: 0

摘要

急性右心室功能衰竭（RVF）普遍存在于多种疾病状态中，并与不良的临床预后有关。右侧临时机械循环支持（tMCS）装置用于为血流动力学上有明显 RVF 的心源性休克（CS）患者解除 RV 充血负荷并增加心输出量。目前有多种 RV-tMCS 设备平台可供选择，但在患者选择、升级到 RV-tMCS 的时机、设备管理和设备断奶方面缺乏共识。本综述的目的是：1）描述治疗伴有 CS 的急性 RVF 的 tMCS 设备疗法的现状；2）讨论升级到 RV-tMCS 设备疗法的原则；3）研究 RV-tMCS 设备支持的患者临床管理的重要方面，包括容量管理、抗凝和正压通气；4）提供 RV-tMCS 断流的框架。

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Pragmatic approach to temporary mechanical circulatory support in acute right ventricular failure

Acute right ventricular failure (RVF) is prevalent in multiple disease states and is associated with poor clinical outcomes. Right-sided temporary mechanical circulatory support (tMCS) devices are used to unload RV congestion and increase cardiac output in cardiogenic shock (CS) with hemodynamically significant RVF. Several RV-tMCS device platforms are available; however consensus is lacking on patient selection, timing of escalation to RV-tMCS, device management, and device weaning. The purposes of this review are to 1) describe the current state of tMCS device therapies for acute RVF with CS, 2) discuss principles of escalation to RV-tMCS device therapy, 3) examine important aspects of clinical management for patients supported by RV-tMCS devices including volume management, anticoagulation, and positive pressure ventilation, and 4) provide a framework for RV-tMCS weaning.

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来源期刊

Journal of Heart and Lung Transplantation 医学-呼吸系统

CiteScore

10.10

自引率

6.70%

发文量

1667

审稿时长

69 days

期刊介绍： The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.