Mechanical Circulatory Support in Shock

In recent years, mechanical circulatory support (MCS) systems have become increasingly important in the acute medical treatment of critically ill patients in shock. Currently, various systems are available in Europe, which differ significantly in their mode of action and field of application. In addition to MCS characteristics and center expertise, patient characteristics must also be taken into account when selecting the right MCS. Different types of shock require differentiated therapy, depending on the etiology of the shock and its hemodynamic accentuation (e.g., infarct-related cardiogenic shock with leading left heart failure requires different therapy than infarct-related cardiogenic shock with leading right heart failure). The selection of the particular cardiac support system depends on the pathophysiology of the underlying disease. At times, combinations of multiple support systems are required. This review article discusses the different systems (extracorporeal membrane oxygenation, intraaortic balloon pump, microaxillary pump/percutaneous left ventricular support system, percutaneous right ventricular support system) and their potential use in the context of the different types of shock.