Mechanical Support of the Failing Heart
First Things First
- Indications for mechanical support: NYHA class IV heart failure secondary to ischemic or non-ischemic cardiomyopathy (viral, peripartum, alcoholic, infiltrative)
- What is accomplished by providing mechanical support? Offloads the failed ventricle, allows time for recovery, supports end organs
- What options are available? Pulsatile and non-pulsatile (axial flow) devices exist, and best individual fit is determined by a combination of size, durability, and etiology of heart failure.
- Which physiologic parameters are controlled by the device?
- Pump output = pump rate x pump stroke volume
- Pump rate may be adjusted by changing pump frequency (pulsatile) or revolutions per minute (axial flow).
- Stroke volume (or equivalent) may be adjusted by adding vacuum to pulsatile devices or adjusting afterload for axial flow devices.
- CO = HR x SV
- Pump output = pump rate x pump stroke volume
- Which physiologic parameters can be controlled medically or pharmacologically? Preload, pulmonary vascular resistance, native heart rhythm, systemic vascular resistance, native heart contractility
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Last updated: May 8, 2010
Citation
"Mechanical Support of the Failing Heart." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534057/4/Mechanical_Support_of_the_Failing_Heart.
Mechanical Support of the Failing Heart. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534057/4/Mechanical_Support_of_the_Failing_Heart. Accessed October 5, 2024.
Mechanical Support of the Failing Heart. (2010). In Pocket ICU Management. PocketMedicine.com, Inc. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534057/4/Mechanical_Support_of_the_Failing_Heart
Mechanical Support of the Failing Heart [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2024 October 05]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534057/4/Mechanical_Support_of_the_Failing_Heart.
* Article titles in AMA citation format should be in sentence-case
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