skip to main content
Idioma:

The response of the microcirculation to mechanical support of the heart in critical illness

Akin, Sakir, MD ; Kara, Atila, MD ; den Uil, Corstiaan A., MD, PhD ; Ince, Can, PhD

Best practice & research. Clinical anaesthesiology, 2016-12, Vol.30 (4), p.511-522 [Periódico revisado por pares]

Netherlands: Elsevier Ltd

Texto completo disponível

Citações Citado por
  • Título:
    The response of the microcirculation to mechanical support of the heart in critical illness
  • Autor: Akin, Sakir, MD ; Kara, Atila, MD ; den Uil, Corstiaan A., MD, PhD ; Ince, Can, PhD
  • Assuntos: Anesthesia & Perioperative Care ; cardiogenic shock ; Critical Illness ; Heart - physiopathology ; heart failure ; Heart Failure - physiopathology ; Heart Failure - therapy ; Heart-Assist Devices ; hemodynamic coherence ; Hemodynamics ; Humans ; mechanical circulatory support ; Microcirculation
  • É parte de: Best practice & research. Clinical anaesthesiology, 2016-12, Vol.30 (4), p.511-522
  • Descrição: Abstract Critical illness associated with cardiac pump failure results in reduced tissue perfusion in all organs and occurs in various conditions such as sepsis, cardiogenic shock and heart failure. Mechanical circulatory support (MCS) devices can be used to maintain organ perfusion in patients with cardiogenic shock and decompensated chronic heart failure. However, correction of global hemodynamic parameters by MCS do not always cause a parallel improvement in microcirculatory perfusion and oxygenation of the organ systems, a condition referred to as a loss of hemodynamic coherence between macro- and microcirculation. In this paper we review the literature describing hemodynamic coherence or loss there in occurring during MCS of the heart. Using Embase, Medline Cochrane, Web-of-science and Google scholar we analysed the literature the response of micro- and macrocirculation to MCS of the heart in critical illness. The characteristics of patients, MCS devices and micro- and macrocirculatory parameters were very heterogenic. Short-term MCS studies (78%) described the effects of intra-aortic balloon pumps (IABP) on the micro- and macrocirculation. Improvement in microcirculation (MC), observed by hand held microscopy (OPS, SDF and CytocamIDF imaging) in line with restored macrocirculation was found in respectively in 44 % and 40% of the studies of short- and long-term MCS. In only 6 out of 14 studies, hemodynamic coherence was described. It is concluded that more studies using direct visualisation of the microcirculation in short- and long-term MCS using hand held microscopy, is needed, preferably in randomized controlled studies, to identify the presence and clinical significance of hemodynamic coherence In doing so it is anticipated that patients who will benefit from treatment by mechanical heart support to ensure adequate organ perfusion can be better identified.
  • Editor: Netherlands: Elsevier Ltd
  • Idioma: Inglês
Links
Voltar para lista de resultados

  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

Buscando em bases de dados remotas. Favor aguardar.