Comparative Effectiveness of Mechanical Circulatory Support Devices in Cardiogenic Shock

Abstract

In patients with cardiogenic shock, this review compares the efficacy of percutaneous microaxial left ventricular assist devices (pLVADs) to intra-aortic balloon pumps (IABPs) or no mechanical circulatory support (MCS). End-organ hypoperfusion brought on by insufficient cardiac output characterizes the potentially fatal disease known as cardiogenic shock. Relevant papers were found by a thorough search of internet resources and were incorporated into the study. The main outcomes evaluated were: (1) Short-term mortality, (2) hemodynamic indices, (3) organ function, and (4) Length of hospital stay. Considered secondary outcomes were: (1) Adverse events, (2) quality of life, and (3) long-term survival. As shown by increased cardiac output and mean arterial pressure, the findings of this research imply that pLVADs may provide superior hemodynamic support versus IABPs or no MCS. In addition, pLVADs may have better organ function and lower short-term mortality rates than IABPs or no MCS. However, using pLVADs was also linked to a higher risk of unfavorable outcomes, such as bleeding and vascular issues. Data on long-term survival and quality-of-life outcomes were sparse and ambiguous. In conclusion, as compared to IABPs or no MCS, pLVADs may offer more effective hemodynamic support and better short-term outcomes in patients with cardiogenic shock. More investigation is required to fully comprehend the long-term advantages, hazards, and effects of pLVADs on the quality of life in this patient population.