Abstract
Cardiogenic shock is a complex and heterogeneous pathological condition characterized by impaired contractile function of the heart. The goal of cardiogenic shock treatment is to improve abnormal hemodynamics and maintain adequate tissue perfusion. If hypotension and inadequate tissue perfusion persist despite initial therapy, temporary mechanical circulatory support (t-MCS) should be initiated. This decade has witnessed the advent of a new era in cardiogenic shock management by the use of t-MCS through accumulated experience with intra-aortic balloon pumps (IABP) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO), as well as revolutionary novel devices or systems like axial flow pumps (Impella) and the combination of VA-ECMO and Impella (ECPELLA) based on knowledge of circulatory physiology. In this transitional phase, we refined our cardiogenic shock management strategy using t-MCS. The management strategy involves carefully choosing single or combining t-MCS devices based on the characteristics of each device and the specific pathological condition. This selection is guided by hemodynamic monitoring, shock staging, risk stratification, and coordinated management by a multidisciplinary shock team.
