Nonpharmacologic Management of Cardiac Arrest and Cardiogenic Shock

¹ The Research and Congestive Heart Failure Divisions, Minneapolis Heart Institute Foundation, Minneapolis.

Patients with cardiogenic shock or cardiac arrest unresponsive to pharmacologic therapy need prompt intervention. Present technology now allows for total circulatory support with mechanical circulatory assist devices. In addition, prompt circulatory support can be provided with presently available devices within minutes even outside the operating room. Advances in percutaneous interventional therapy and surgical treatment have led to improvement in short-and long-term survival in patients with these problems. There are, however, numerous patients with irreversible cardiac dysfunction who need cardiac transplantation. However, because of limitation of donor hearts, many of these patients die prior to transplantation. In addition, many patients with irreversible cardiac dysfunction are not candidates for transplantation. The development of permanent mechanical assist devices is ongoing, and it is presently believed their development is feasible. It is hopeful that once permanent mechanical circulatory assist devices are available, even greater gains regarding improved survival will be forthcoming.