Kreislaufunterstützungssysteme in der internistischen Intensivmedizin

Der kardiogene Schock und die akute Herzinsuffizienz sind lebensbedrohlich. Mechanische Kreislaufunterstützungssysteme dienen der hämodynamischen Stabilisierung von kritisch Kranken in dieser Situation. Grundsätzlich kann zwischen invasiven und nichtinvasiven Kreislaufunterstützungssystemen unterschieden werden. Dieser Artikel stellt die derzeit verfügbaren Systeme vor.

Schlüsselwörter

kardiogener Schock - Katecholamine - Myokardinfarkt - Assist Device

• Literatur

• 1 Goldberg RJ, Gore JM, Alpert JS. et al. Cardiogenic shock after acute myocardial infarction. Incidence and mortality from a community-wide perspective, 1975 to 1988. N Engl J Med 1991; 325: 1117-1122 doi:10.1056/nejm199110173251601
• 2 Kolte D, Khera S, Dabhadkar KC. et al. Trends in coronary angiography, revascularization, and outcomes of cardiogenic shock complicating non-ST-Elevation myocardial infarction. Am J Cardiol 2016; 117: 1-9 doi:10.1016/j.amjcard.2015.10.006
• 3 Ferrari M, Kruzliak P, Spiliopoulos K. An insight into short- and long-term mechanical circulatory support systems. Clin Res Cardiol 2015; 104: 95-111 doi:10.1007/s00392-014-0771-6
• 4 Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA 1960; 173: 1064-1067
• 5 Ferrari MW. Welche Bedeutung haben mechanische Assist-Systeme beim Herz-Kreislauf-Stillstand?. Herzschrittmacherther Elektrophysiol 2016; 27: 25-30 doi:10.1007/s00399-016-0421-y
• 6 Kantrowitz A. Experimental augmentation of coronary flow by retardation of the arterial pressure pulse. Surgery 1953; 34: 678-687
• 7 Kovack PJ, Rasak MA, Bates ER. et al. Thrombolysis plus aortic counterpulsation: improved survival in patients who present to community hospitals with cardiogenic shock. J Am Coll Cardiol 1997; 29: 1454-1458
• 8 Ohman EM, Nanas J, Stomel RJ. et al. Thrombolysis and counterpulsation to improve survival in myocardial infarction complicated by hypotension and suspected cardiogenic shock or heart failure: results of the TACTICS Trial. J Thrombosis Thrombolysis 2005; 19: 33-39 doi:10.1007/s11239-005-0938-0
• 9 Kern MJ, Aguirre FV, Caracciolo EA. et al. Hemodynamic effects of new intra-aortic balloon counterpulsation timing methods in patients: a multicenter evaluation. Am Heart J 1999; 137: 1129-1136
• 10 Sjauw KD, Engstrom AE, Vis MM. et al. A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines?. Eur Heart J 2009; 30: 459-468 doi:10.1093/eurheartj/ehn602
• 11 Thiele H, Zeymer U, Neumann FJ. et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med 2012; 367: 1287-1296 doi:10.1056/NEJMoa1208410
• 12 Lauten A, Engstrom AE, Jung C. et al. Percutaneous left-ventricular support with the Impella-2.5-assist device in acute cardiogenic shock: results of the Impella-EUROSHOCK-registry. Circulation Heart Fail 2013; 6: 23-30 doi:10.1161/circheartfailure.112.967224
• 13 Ouweneel DM, Eriksen E, Sjauw KD. et al. Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction. J Am Coll Cardiol 2017; 69: 278-287 doi:10.1016/j.jacc.2016.10.022
• 14 OʼNeill WW, Kleiman NS, Moses J. et al. A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. Circulation 2012; 126: 1717-1727 doi:10.1161/circulationaha.112.098194
• 15 Van Mieghem NM, Daemen J, den Uil C. et al. Design and Principle of Operation of the HeartMate PHPTM (Percutaneous Heart Pump). EuroIntervention 2016;
• 16 Smith EJ, Reitan O, Keeble T. et al. A first-in-man study of the Reitan catheter pump for circulatory support in patients undergoing high-risk percutaneous coronary intervention. Catheter Cardiovasc Intervent 2009; 73: 859-865 doi:10.1002/ccd.21865
• 17 Wang S, Izer JM, Clark JB. et al. In Vivo hemodynamic performance evaluation of novel electrocardiogram-synchronized pulsatile and nonpulsatile extracorporeal life support systems in an adult swine model. Art Organs 2015; 39: E90-Ee101 doi:10.1111/aor.12482
• 18 Mehlhorn U, Brieske M, Fischer UM. et al. LIFEBRIDGE: a portable, modular, rapidly available “plug-and-play” mechanical circulatory support system. Ann Thorac Surg 2005; 80: 1887-1892 doi:10.1016/j.athoracsur.2005.03.040
• 19 Burkhoff D, Cohen H, Brunckhorst C. et al. A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock. Am Heart J 2006; 152: 469.e1-e8 doi:10.1016/j.ahj.2006.05.031
• 20 Werdan K, Russ M, Buerke M. et al. Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a German-Austrian S3 Guideline. Dtsch Arztebl Int 2012; 109: 343-351 doi:10.3238/arztebl.2012.0343