Therapeutic Phases in the Cardiogenic Shock—Part 2—Optimization of Mechanical Circulatory Support

Temporary mechanical circulatory support (MCS) can provide effective hemodynamic support in cardiogenic shock. The institution of temporary MCS must be followed by optimization of the therapy. Temporary MCS are highly invasive interventions, the benefit in improving survival in cardiogenic shock must be weighed against the risks of major complications. The full benefit of temporary MCS can only be realized if the complications can be avoided or minimized, the hemodynamic effects optimized in appropriately selected patients with cardiogenic shock. This Chapter will discuss the management of MCS-related complications and optimization of systemic blood flow, oxygen delivery and blood pressure with temporary MCS.