Mechanical circulatory support: the last resort in cardiogenic shock?

Cardiogenic shock (CS) occurs in up to 10% of all patients with acute myocardial infarction (AMI) and the mortality rate remains high, approaching 50% depending on the risk profile of the cohort. Standard therapy includes optimal fluid management as well as administration of vasopressors and inotropes on top of a causal treatment of the underlying condition. Although catecholamines play an essential role in the supportive care of CS patients, their benefits on haemodynamics appear to be counterbalanced by adverse effects such as increased myocardial oxygen demand, arrhythmogenicity, and compromise of tissue microcirculation which may translate into an increased mortality risk1. Mechanical ...