Читать книгу Emergency Medical Services - Группа авторов - Страница 274

Categories of short‐term mechanical circulatory support devices used to manage acute cardiogenic shock include intra‐aortic balloon pumps (IABPs), non‐IABP percutaneous mechanical circulatory support devices, extracorporeal membrane oxygenator (ECMO) pumps, and nonpercutaneous centrifugal pumps (cardiopulmonary bypass). Each improves end‐organ perfusion, reduces intracardiac filling pressures, reduces left ventricular volumes and myocardial oxygen consumption, and augments coronary perfusion. Each type of device results in specific complexities and challenges during interfacility transport. Often, the required expertise necessitates that an experienced team be involved. Teams may be composed of critical care paramedics, nurses, and physicians who are specially trained to address complications with these devices and able to support the patient in the event of device failure. For example, in the case of ECMO, it is important that a perfusionist or other specialist is part of the team and dedicated to managing the pump [1].