title: [Cardiac support and replacement therapies].
abstract: Circulatory support represents an integral part within the treatment of the critically ill patient. Sophisticated pharmacologic regimens help to maintain systemic perfusion pressure by increasing vascular tone as well as mediating positive inotropic effects. Besides the administration of catecholamines and phosphodiesterase-III-inhibitors, in particular the administration of levosimendan represents a promising alternative during low-cardiac-output. Nevertheless, sufficient evidence demonstrating a survival benefit for any pharmacologic regimen is nonexistent. In case pharmacological measures do not suffice mechanical cardiopulmonary support (MCS) may be used. MCS may be used during cardiopulmonary resuscitation or a "low-cardiac-output-syndrome" as bridging towards decision, recovery or long-term support. Venoarterial extracorporeal membrane oxygenation (vaECMO) may take over cardiopulmonary function and may improve survival as well as neurological outcome after cardiogenic shock or cardiopulmonary resuscitation.
authors.affiliation: Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lotz
authors.affiliation: Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg.
authors.forename: Norbert
authors.initials: N
authors.lastname: Roewer
authors.affiliation: Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg.
authors.forename: Ralf M
authors.initials: RM
authors.lastname: Muellenbach
mesh_terms: D002316:Cardiotonic Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000379:methods; D003422:Critical Care / Q000379:methods; D019317:Evidence-Based Medicine; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D016027:Heart Transplantation / Q000295:instrumentation / Q000379:methods*; D006353:Heart-Assist Devices; D006801:Humans; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents