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Emerg Med Clin North Am. 2014 Nov;32(4):851-69. doi: 10.1016/j.emc.2014.07.009. Epub 2014 Aug 28.

Mechanical circulatory support.

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Division of Pulmonary & Critical Care Medicine, University of Maryland School of Medicine, 110 South Paca Street, 2nd Floor, Baltimore, MD 21201, USA. Electronic address:
Critical Care Service, Cardiac Surgery ICU, Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA.


The role for temporary and durable mechanical circulatory support is rapidly expanding. As the use of these technologies continues to grow, the emergency physician has an increasing opportunity to participate in the advancement of these potentially life-saving technologies. This review discusses the current role of the intra-aortic balloon pump in cardiogenic shock, describes the complications and management strategies for the critically ill patient with a left ventricular assist device, and explores the emerging role of ECMO in the emergency department for patients presenting in refractory cardiogenic shock and cardiac arrest.


Cardiogenic shock; Extracorporeal membrane oxygenation (ECMO); Intra-aortic balloon pump; Mechanical circulatory support; Ventricular assist device

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