Organersatzverfahren - Kreislaufunterstützung und -ersatz

Zusammenfassung

Kreislaufunterstützende Maßnahmen sind ein unverzichtbarer Bestandteil in der Versorgung kritisch Kranker. Eine differenzierte pharmakologische Therapie erlaubt die Aufrechterhaltung des systemischen Perfusionsdrucks durch Erhöhung des peripheren Widerstands und positiver Inotropie. Neben der Gabe von Katecholaminen und Phosphodiesterase-3-Inhibitoren zeigt sich insbesondere die Gabe von Levosimendan als vielversprechende Alternative beim Low-Cardiac-Output-Syndrom. Gleichwohl existiert für kein medikamentöses Therapieregime eine ausreichende Evidenz im Hinblick auf ein verbessertes Überleben. Mechanische Herz-Kreislauf-Unterstützung ist bei Versagen medikamentöser Maßnahmen, z.B. während kardiopulmonaler Reanimation, Low-Cardiac-Output-Syndrom, zur kurz- bis mittelfristigen Herz-Kreislauf-Unterstützung indiziert („bridging to decision and recovery“). Die venoarterielle extrakorporale Membranoxygenierung (vaECMO) erlaubt eine komplette Übernahme der kardiopulmonalen Funktion und scheint das Überleben mit gutem neurologischem Outcome bei kardiogenem Schock bzw. kardiopulmonaler Reanimation zu verbessern.

Abstract

Circulatory support represents an integral part within the treatment of the critically ill patient. Sophisticated pharmacologic regimens help to maintain systemic perfusion pressure by increasing vascular tone as well as mediating positive inotropic effects. Besides the administration of catecholamines and phosphodiesterase-III-inhibitors, in particular the administration of levosimendan represents a promising alternative during low-cardiac-output. Nevertheless, sufficient evidence demonstrating a survival benefit for any pharmacologic regimen is nonexistent. In case pharmacological measures do not suffice mechanical cardiopulmonary support (MCS) may be used. MCS may be used during cardiopulmonary resuscitation or a “low-cardiac-output-syndrome” as bridging towards decision, recovery or long-term support. Venoarterial extracorporeal membrane oxygenation (vaECMO) may take over cardiopulmonary function and may improve survival as well as neurological outcome after cardiogenic shock or cardiopulmonary resuscitation.

Kernaussagen

• Eine medikamentöse Kreislaufunterstützung ist eine symptomatische Therapie ohne Nachweis einer höheren Überlebensrate für ein spezifisches Therapieregime.

• Noradrenalin ist als Vasopressor im septischen und kardiogenen Schock 1. Wahl.

• Levosimendan wirkt positiv-inotrop und verbessert die diastolische Funktion ohne Veränderung des myokardialen Sauerstoffverbrauchs. Es ist indiziert zur Kurzeitbehandlung bei dekompensierter Herzinsuffizienz sowie perioperativ bei kardiochirurgischen Patienten mit schlechter Ventrikelfunktion.

• Mechanische Systeme bieten eine wichtige therapeutische Option zur raschen Unterstützung des Herzens bis hin zur Übernahme der kardiopulmonalen Funktion.

• Die hämodynamischen Wirkungen einer IABP werden kontrovers diskutiert, wobei durch ihren Einsatz bisher kein Überlebensvorteil im kardiogenen Schock nachgewiesen wurde.

• Indikationen der veno-arteriellen ECMO (vaECMO) umfassen u.a. den kardiogenen Schock, die extrakorporale Reanimation (E-CPR), eine fulminante Lungenarterienembolie und die septische Kardiomyopathie.

• Bei der vaECMO geht die kardiale Unterstützung bei peripherer Kanülenanlage mit einer flussabhängigen Zunahme der linksventrikulären Nachlast einher. Bei insuffizienter Pumpfunktion kann es in dieser Konstellation daher zum Ausbleiben der Aortenklappenöffnung mit Rückstau in die pulmonale Zirkulation kommen.

• Eine Entlastung des linken Ventrikels unter vaECMO kann durch eine zusätzliche Anlage einer Impella-Pumpe oder des TandemHearts erreicht werden.

Schlüsselwörter:

Kreislaufunterstützung - extrakorporale Membranoxygenierung - Katecholamine - Levosimendan - Phosphodiesterase-3-Inhibitoren

Keywords:

cardiac support - extracorporeal membrane oxygenation - catecholamines - levosimendan - phosphodiesterase-III-inhibitors

• Literatur

• 1 Amsallem E, Kasparian C, Haddour G et al. Phosphodiesterase III inhibitors for heart failure. Cochrane Database Syst Rev 2005 (Suppl. 01) CD002230
• 2 Annane D, Vignon P, Renault A et al. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet 2007; 370: 676-684
• 3 Antila S, Pesonen U, Lehtonen L et al. Pharmacokinetics of levosimendan and its active metabolite OR-1896 in rapid and slow acetylators. Eur J Pharm Sci 2004; 23: 213-222
• 4 Asaumi Y, Yasuda S, Morii I et al. Favourable clinical outcome in patients with cardiogenic shock due to fulminant myocarditis supported by percutaneous extracorporeal membrane oxygenation. Eur Heart J 2005; 26: 2185-2192
• 5 Asfar P, Meziani F, Hamel JF et al. High versus low blood-pressure target in patients with septic shock. N Engl J Med 2014; 370: 1583-1593
• 6 Aubron C, Cheng AC, Pilcher D et al. Factors associated with outcomes of patients on extracorporeal membrane oxygenation support: a 5-year cohort study. Crit Care 2013; 17: R73
• 7 Badiye AP, Hernandez GA, Novoa I et al. Incidence of hemolysis in patients with cardiogenic shock treated with impella percutaneous left ventricular assist device. ASAIO J 2016; 62: 11-14
• 8 Bellomo R, Chapman M, Finfer S et al. Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Lancet 2000; 356: 2139-2143
• 9 Brechot N, Luyt CE, Schmidt M et al. Venoarterial extracorporeal membrane oxygenation support for refractory cardiovascular dysfunction during severe bacterial septic shock. Crit Care Med 2013; 41: 1616-1626
• 10 Cardarelli MG, Young AJ, Griffith B. Use of extracorporeal membrane oxygenation for adults in cardiac arrest (E-CPR): a meta-analysis of observational studies. ASAIO J 2009; 55: 581-586
• 11 Christenson JT, Badel P, Simonet F et al. Preoperative intraaortic balloon pump enhances cardiac performance and improves the outcome of redo CABG. Ann Thorac Surg 1997; 64: 1237-1244
• 12 De Backer D, Biston P, Devriendt J et al Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 2010; 362: 779-789
• 13 De Backer D, Creteur J, Silva E et al Effects of dopamine, norepinephrine, and epinephrine on the splanchnic circulation in septic shock: which is best?. Crit Care Med 2003; 31: 1659-1667
• 14 Dellinger RP, Levy MM, Rhodes A et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013; 39: 165-228
• 15 Engstrom AE, Cocchieri R, Driessen AH et al. The Impella 2.5 and 5.0 devices for ST-elevation myocardial infarction patients presenting with severe and profound cardiogenic shock: the Academic Medical Center intensive care unit experience. Crit Care Med 2001; 39: 2072-2079
• 16 Fagnoul D, Combes A, De Backer D. Extracorporeal cardiopulmonary resuscitation. Curr Opin Crit Care 2014; 20: 259-265
• 17 Fayssoil A, Nardi O, Orlikowski D et al. Percutaneous extracorporeal membrane oxygenation for cardiogenic shock due to acute fulminant myocarditis. Ann Thorac Surg 2010; 89: 614-616
• 18 Feneck RO, Sherry KM, Withington PS et al. Comparison of the hemodynamic effects of milrinone with dobutamine in patients after cardiac surgery. J Cardiothorac Vasc Anesth 2001; 15: 306-315
• 19 Gaudard P, Mourad M, Eliet J et al. Management and outcome of patients supported with Impella 5.0 for refractory cardiogenic shock. Crit Care 2015; 19: 363
• 20 Givertz MM, Andreou C, Conrad CH et al. Direct myocardial effects of levosimendan in humans with left ventricular dysfunction: alteration of force-frequency and relaxation-frequency relationships. Circulation 2007; 115: 1218-1224
• 21 Griffith BP, Anderson MB, Samuels LE et al. The RECOVER I: a multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support. J Thorac Cardiovasc Surg 2013; 145: 548-554
• 22 Gueugniaud PY, David JS, Chanzy E et al. Vasopressin and epinephrine vs. epinephrine alone in cardiopulmonary resuscitation. N Engl J Med 2008; 359: 21-30
• 23 Haikala H, Nissinen E, Etemadzadeh E et al. Troponin C-mediated calcium sensitization induced by levosimendan does not impair relaxation. J Cardiovasc Pharmacol 1995; 25: 794-801
• 24 Han SJ, Kim HS, Choi HH et al. Predictors of survival following extracorporeal cardiopulmonary resuscitation in patients with acute myocardial infarction-complicated refractory cardiac arrest in the emergency department: a retrospective study. J Cardiothorac Surg 2015; 10: 23
• 25 Harrison RW, Hasselblad V, Mehta RH et al. Effect of levosimendan on survival and adverse events after cardiac surgery: a meta-analysis. J Cardiothorac Vasc Anesth 2013; 27: 1224-1232
• 26 Hazinski MF, Nolan JP, Aickin R et al. Part 1: Executive Summary: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2015; 132 (Suppl. 01) S2-39
• 27 Heilmann C, Geisen U, Beyersdorf F et al. Acquired von Willebrand syndrome in patients with extracorporeal life support (ECLS). Intensive Care Med 2012; 38: 62-68
• 28 Heyland DK, Kernerman P, Gafni A et al. Economic evaluations in the critical care literature: do they help us improve the efficiency of our unit?. Crit Care Med 1996; 24: 1591-1598
• 29 Hollenberg SM. Vasoactive drugs in circulatory shock. Am J Respir Crit Care Med 2011; 183: 847-855
• 30 Hollenberg SM, Ahrens TS, Annane D et al. Practice parameters for hemodynamic support of sepsis in adult patients: 2004 update. Crit Care Med 2004; 32: 1928-1948
• 31 Holman WL, Li Q, Kiefe CI et al. Prophylactic value of preincision intra-aortic balloon pump: analysis of a statewide experience. J Thorac Cardiovasc Surg 2000; 120: 1112-1119
• 32 Holmes CL, Walley KR, Chittock DR et al. The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series. Intensive Care Med 2001; 27: 1416-1421
• 33 Honerjager P. Pharmacology of positive inotropic phosphodiesterase III inhibitors. Eur Heart J 1989; 10 (Suppl. C) 25-31
• 34 Jakob SM, Ruokonen E, Takala J. Effects of dopamine on systemic and regional blood flow and metabolism in septic and cardiac surgery patients. Shock 2002; 18: 8-13
• 35 Kantrowitz A, Tjonneland S, Freed PS et al. Initial clinical experience with intraaortic balloon pumping in cardiogenic shock. JAMA 1968; 203: 113-118
• 36 Keller D, Lotz C, Kippnich M et al. Venoarterielle extrakorporale Membranoxygenierung am wachen Patienten – Einsatz des mobilen ECMO-Teams bei fulminanter Lungenarterienembolie. Anaesthesist 2015; 64: 385-389
• 37 Kippnich M, Lotz C, Kredel M et al. Venoarterielle extrakorporale Membranoxygenierung beim präklinischen Herz-Kreislauf-Stillstand – Fallserie prä- und innerklinischer Behandlungen. Anaesthesist 2015; 64: 580-585
• 38 Kivikko M, Antila S, Eha J et al. Pharmacodynamics and safety of a new calcium sensitizer, levosimendan, and its metabolites during an extended infusion in patients with severe heart failure. J Clin Pharmacol 2002; 42: 43-51
• 39 Kovacic JC, Nguyen HT, Karajgikar R et al. The Impella Recover 2.5 and TandemHeart ventricular assist devices are safe and associated with equivalent clinical outcomes in patients undergoing high-risk percutaneous coronary intervention. Catheter Cardiovasc Interv 2013; 82: E28-37
• 40 Kustermann J, Brederlau J, Kranke P et al. Lungenersatzverfahren – Einsatz und Management extrakorporaler Lungenersatzverfahren. Anasthesiol Intensivmed Notfallmed Schmerzther 2012; 47: 646-654
• 41 Kustermann J, Gehrmann A, Kredel M et al. Akutes Lungenversagen und septische Kardiomyopathie – Erfolgreicher Einsatz der veno-venoarteriellen extrakorporalen Membranoxygenierung. Anaesthesist 2013; 62: 639-643
• 42 Landry DW, Levin HR, Gallant EM et al. Vasopressin deficiency contributes to the vasodilation of septic shock. Circulation 1997; 95: 1122-1125
• 43 Lauten A, Engstrom AE, Jung C et al. Percutaneous left-ventricular support with the Impella-2.5-assist device in acute cardiogenic shock: results of the Impella-EUROSHOCK-registry. Circ Heart Fail 2013; 6: 23-30
• 44 Levin R, Degrange M, Del Mazo C et al Preoperative levosimendan decreases mortality and the development of low cardiac output in high-risk patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting with cardiopulmonary bypass. Exp Clin Cardiol 2012; 17: 125-130
• 45 Levine GN, Bates ER, Blankenship JC et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol 2011; 58: e44-122
• 46 Levy B, Perez P, Perny J et al. Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. Crit Care Med 2011; 39: 450-455
• 47 Lilleberg J, Laine M, Palkama T et al. Duration of the haemodynamic action of a 24-h infusion of levosimendan in patients with congestive heart failure. Eur J Heart Fail 2007; 9: 75-82
• 48 Lindner KH, Dirks B, Strohmenger HU et al. Randomised comparison of epinephrine and vasopressin in patients with out-of-hospital ventricular fibrillation. Lancet 1997; 349: 535-537
• 49 Lotz C, Ritter O, Muellenbach RM. Assisted beating of the ischemic heart: how to manage the pulseless ST-segment-elevation myocardial infarction patient. Circulation 2014; 130: 1095-1104
• 50 Lunz D, Philipp A, Dolch M et al. Venoarterielle extrakorporale Membranoxygenierung – Indikationen, Limitationen und praktische Anwendung. Anaesthesist 2014; 63: 625-635
• 51 Marik PE, Mohedin M. The contrasting effects of dopamine and norepinephrine on systemic and splanchnic oxygen utilization in hyperdynamic sepsis. JAMA 1994; 272: 1354-1357
• 52 Martin C, Viviand X, Leone M et al. Effect of norepinephrine on the outcome of septic shock. Crit Care Med 2000; 28: 2758-2765
• 53 Mcmurray JJ, Adamopoulos S, Anker SD et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA). of the ESC. Eur J Heart Fail 2012; 14: 803-869
• 54 Mebazaa A, Nieminen MS, Filippatos GS et al. Levosimendan vs. dobutamine: outcomes for acute heart failure patients on beta-blockers in SURVIVE. Eur J Heart Fail 2009; 11: 304-311
• 55 Mendiratta P, Wei JY, Gomez A et al. Cardiopulmonary resuscitation requiring extracorporeal membrane oxygenation in the elderly: a review of the Extracorporeal Life Support Organization registry. ASAIO J 2013; 59: 211-215
• 56 Mentzelopoulos SD, Malachias S, Chamos C et al. Vasopressin, steroids, and epinephrine and neurologically favorable survival after in-hospital cardiac arrest: a randomized clinical trial. JAMA 2013; 310: 270-279
• 57 Miceli A, Fiorani B, Danesi TH et al. Prophylactic intra-aortic balloon pump in high-risk patients undergoing coronary artery bypass grafting: a propensity score analysis. Interact Cardiovasc Thorac Surg 2009; 9: 291-294
• 58 Michaels AD, Mckeown B, Kostal M et al. Effects of intravenous levosimendan on human coronary vasomotor regulation, left ventricular wall stress, and myocardial oxygen uptake. Circulation 2005; 111: 1504-1509
• 59 Mirabel M, Luyt CE, Leprince P et al. Outcomes, long-term quality of life, and psychologic assessment of fulminant myocarditis patients rescued by mechanical circulatory support. Crit Care Med 2011; 39: 1029-1035
• 60 Mosca MS, Narotsky DL, Mochari-Greenberger H et al. Duration of conventional cardiopulmonary resuscitation prior to extracorporeal cardiopulmonary resuscitation and survival among adult cardiac arrest patients. Perfusion 2016; 31: 200-206
• 61 Muller T, Philipp A, Lubnow M et al. First application of a new portable, miniaturized system for extracorporeal membrane oxygenation. Perfusion 2011; 26: 284-288
• 62 Myburgh JA, Higgins A, Jovanovska A et al. A comparison of epinephrine and norepinephrine in critically ill patients. Intensive Care Med 2008; 34: 2226-2234
• 63 Naidu SS. Novel percutaneous cardiac assist devices: the science of and indications for hemodynamic support. Circulation 2011; 123: 533-543
• 64 Nanjayy VB, Murphy D. Ultrasound Guidance for Extracorporeal Membrane Oxygenation. Veno-Venous ECMO specific guidelines. Ann Arbor: The Extracorporeal Life Support Organization; 2011
• 65 Neumar RW, Shuster M, Callaway CW et al. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132 (Suppl. 02) S315-367
• 66 O‘Neill WW, Kleiman NS, Moses J et al A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. Circulation 2012; 126: 1717-1727
• 67 Oberbeck R, Schmitz D, Wilsenack K et al. Dopamine affects cellular immune functions during polymicrobial sepsis. Intensive Care Med 2006; 32: 731-739
• 68 Oliver G, Schafer EA. On the physiological action of extracts of pituitary body and certain other glandular organs: preliminary communication. J Physiol 1895; 18: 277-279
• 69 Oliver WC. Anticoagulation and coagulation management for ECMO. Semin Cardiothorac Vasc Anesth 2009; 13: 154-175
• 70 Ong ME, Tiah L, Leong BS et al. A randomised, double-blind, multi-centre trial comparing vasopressin and adrenaline in patients with cardiac arrest presenting to or in the Emergency Department. Resuscitation 2012; 83: 953-960
• 71 Extracorporeal Life Support Organization (ELSO). Guidelines for Cardiopulmonary Extracorporeal Life Support. Version 1.3 11/2013;
• 72 Extracorporeal Life Support Organization (ELSO). Guidelines for Adult Cardiac Failure. Version 1.3 12/2013;
• 73 Extracorporeal Life Support Organization (ELSO). Guidelines for Adult Respiratory Failure. Version 1.3 12/2013;
• 74 Paden ML, Conrad SA, Rycus PT et al. Extracorporeal Life Support Organization Registry Report 2012. ASAIO J 2013; 59: 202-210
• 75 Pages ON, Aubert S, Combes A et al. Paracorporeal pulsatile biventricular assist device versus extracorporal membrane oxygenation-extracorporal life support in adult fulminant myocarditis. J Thorac Cardiovasc Surg 2009; 137: 194-197
• 76 Pollesello P, Ovaska M, Kaivola J et al. Binding of a new Ca²⁺ sensitizer, levosimendan, to recombinant human cardiac troponin C. A molecular modelling, fluorescence probe, and proton nuclear magnetic resonance study. J Biol Chem 1994; 269: 28584-28590
• 77 Rehder KJ, Turner DA, Bonadonna D et al. Technological advances in extracorporeal membrane oxygenation for respiratory failure. Expert Rev Respir Med 2012; 6: 377-384
• 78 Russell JA, Walley KR, Singer J et al. Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med 2008; 358: 877-887
• 79 Sandell EP, Hayha M, Antila S et al. Pharmacokinetics of levosimendan in healthy volunteers and patients with congestive heart failure. J Cardiovasc Pharmacol 1995; 26 (Suppl. 01) S57-62
• 80 Santarpino G, Onorati F, Rubino AS et al. Preoperative intraaortic balloon pumping improves outcomes for high-risk patients in routine coronary artery bypass graft surgery. Ann Thorac Surg 2009; 87: 481-488
• 81 Sarkar C, Basu B, Chakroborty D et al. The immunoregulatory role of dopamine: an update. Brain Behav Immun 2010; 24: 525-528
• 82 Schafer-Korting M, Mutschler E. Pharmacokinetics of bendroflumethiazide alone and in combination with propranolol and hydralazine. Eur J Clin Pharmacol 1982; 21: 315-323
• 83 Sharshar T, Carlier R, Blanchard A et al. Depletion of neurohypophyseal content of vasopressin in septic shock. Crit Care Med 2002; 30: 497-500
• 84 Slawsky MT, Colucci WS, Gottlieb SS et al. Acute hemodynamic and clinical effects of levosimendan in patients with severe heart failure. Study Investigators. Circulation 2000; 102: 2222-2227
• 85 Stone GW, Ohman EM, Miller MF et al. Contemporary utilization and outcomes of intra-aortic balloon counterpulsation in acute myocardial infarction: the benchmark registry. J Am Coll Cardiol 2003; 41: 1940-1945
• 86 Stretch R, Sauer CM, Yuh DD et al. National trends in the utilization of short-term mechanical circulatory support: incidence, outcomes, and cost analysis. J Am Coll Cardiol 2014; 64: 1407-1415
• 87 Swol J, Belohlavek J, Haft JW et al. Conditions and procedures for in-hospital extracorporeal life support (ECLS) in cardiopulmonary resuscitation (CPR) of adult patients. Perfusion 2016; 31: 182-188
• 88 Tauber H, Ott H, Streif W et al. Extracorporeal membrane oxygenation induces short-term loss of high-molecular-weight von Willebrand factor multimers. Anesth Analg 2015; 120: 730-736
• 89 Thiele H, Lauer B, Hambrecht R et al. Reversal of cardiogenic shock by percutaneous left atrial-to-femoral arterial bypass assistance. Circulation 2001; 104: 2917-2922
• 90 Thiele H, Ohman EM, Desch S et al. Management of cardiogenic shock. Eur Heart J 2015; 36: 1223-1230
• 91 Thiele H, Zeymer U, Neumann FJ et al. Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. Lancet 2013; 382: 1638-1645
• 92 Thiele H, Zeymer U, Neumann FJ et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med 2012; 367: 1287-1296
• 93 Toller W, Heringlake M, Guarracino F et al. Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion. Int J Cardiol 2015; 184: 323-336
• 94 Tritapepe L, De Santis V, Vitale D et al Levosimendan pre-treatment improves outcomes in patients undergoing coronary artery bypass graft surgery. Br J Anaesth 2009; 102: 198-204
• 95 Tsuneyoshi I, Yamada H, Kakihana Y et al. Hemodynamic and metabolic effects of low-dose vasopressin infusions in vasodilatory septic shock. Crit Care Med 2001; 29: 487-493
• 96 Unverzagt S, Wachsmuth L, Hirsch K et al. Inotropic agents and vasodilator strategies for acute myocardial infarction complicated by cardiogenic shock or low cardiac output syndrome. Cochrane Database Syst Rev 2014 1 CD009669
• 97 Van Haren FM, Rozendaal FW, Van Der Hoeven J. The effect of vasopressin on gastric perfusion in catecholamine-dependent patients in septic shock. Chest 2003; 124: 2256-2260
• 98 Van Herck JL, Claeys MJ, De Paep R et al Management of cardiogenic shock complicating acute myocardial infarction. Eur Heart J Acute Cardiovasc Care 2015; 4: 278-297
• 99 Van Nunen LX, Noc M, Kapur NK et al Usefulness of intra-aortic balloon pump counterpulsation. Am J Cardiol 2016; 117: 469-476
• 100 Wu MY, Liu YC, Tseng YH et al. Pulmonary embolectomy in high-risk acute pulmonary embolism: the effectiveness of a comprehensive therapeutic algorithm including extracorporeal life support. Resuscitation 2013; 84: 1365-1370
• 101 Yusuff HO, Zochios V, Vuylsteke A. Extracorporeal membrane oxygenation in acute massive pulmonary embolism: a systematic review. Perfusion 2015; 30: 611-616
• 102 Zacharias M, Conlon NP, Herbison GP et al. Interventions for protecting renal function in the perioperative period. Cochrane Database Syst Rev 2008 CD003590