| Abstract [eng] |
Cardiogenic shock is a critical condition when insufficient heart function disrupts normal blood circulation and adequate tissue perfusion. Acute coronary syndromes are the most common cause of cardiogenic shock, but this sudden illness can also be caused by other factors such as decompensated chronic heart failure, acute myocarditis, heart valve disease, or others. Cardiogenic shock is associated with an in-hospital mortality rate of 30% to 50 %. Treatment depends on the etiology of cardiogenic shock and the patient's clinical presentation, but the key principles of treatment remain the removal of the underlying pathology, stabilization of hemodynamics, and overall intensive therapy. Vasopressors and inotropes are primarily administered to stabilize the patient's hemodynamics. Refractory cardiogenic shock occurs in 1,5 % of patients, necessitating the use of mechanical circulatory support devices. An ideal mechanical circulatory device is described as a tool that ensures effective and reliable circulatory support, is easily and quickly deployed, is typically managed and monitored during application, and has few complications. In clinical practice, intra-aortic balloon counterpulsation, short-term ventricular assist devices such as Impella, TandemHeart, and others, as well as extracorporeal membrane oxygenation system are used. Long-term support is provided by long-term ventricular assist devices. The choice of a specific device depends on the duration of support, the extent of assistance required, and the individual patient's goals, thus requiring a multidisciplinary team of specialists to make significant decisions. The aim of this study is to review the possibilities of using mechanical circulatory support devices in the treatment of cardiogenic shock in scientific literature and to analyze a clinical case of post-cardiotomy cardiogenic shock treated with intra-aortic balloon counterpulsation and biventricular Levitronix support. |
