Percutaneous short-term active mechanical support devices in cardiogenic shock: a systematic review and collaborative meta-analysis of randomized trials.

摘要: Aims Evidence on the impact clinical outcome of active mechanical circulatory support (MCS) devices in cardiogenic shock (CS) is scarce. This collaborative meta-analysis randomized trials thus aims to investigate efficacy and safety percutanzeous MCS vs. control CS. Methods results Randomized comparing percutaneous patients with CS were identified through searches medical literature databases. Risk ratios (RR) 95% confidence intervals (95% CI) calculated analyse primary endpoint 30-day mortality device-related complications including bleeding leg ischaemia. Mean differences (MD) for mean arterial pressure (MAP), cardiac index (CI), pulmonary capillary wedge (PCWP), lactate. Four randomizing 148 either TandemHeart (TM) or Impella (R) VR (n = 77) 71) identified. In all four intra-aortic balloon pumping (IABP) served as control. There was no difference (RR 1.01, CI 0.70 1.44, P 0.98, I-2 0%) compared Active significantly increased MAP (MD 11.85 mmHg, 3.39 20.31, 0.02, 32.7%) decreased lactate - 1.36 mmol/ L, 2.52 0.19, 0%, 0.02) at comparable 0.32, 0.24 0.87, 0.14, 44.1%) PCWP 5.59, 15.59 4.40, 81.1%). No significant observed incidence ischaemia 2.64, 0.83 8.39, 0.10, 0%), whereas rate IABP 2.50, 1.55 4.04, <0.001, 0%). Conclusion Results this do not unselected use complicating AMI