Author/Authors :
George, Praveen Department of Internal Medicine - University of Maryland School of Medicine, Baltimore, MD, USA , Srivastava, Mukta C. Division of Cardiology - University of Maryland School of Medicine, Baltimore, MD, USA , Ludmir, Jonathan Division of Cardiology - University of Maryland School of Medicine, Baltimore, MD, USA , Reed, Robert M. Division of Pulmonary and Critical Care Medicine - University of Maryland School of Medicine, Baltimore, MD, USA , Tewelde, Semhar Z. Department of Emergency Medicine - University of Maryland School of Medicine, Baltimore, MD, USA , Gupta, Anuj Division of Cardiology - University of Maryland School of Medicine, Baltimore, MD, USA , McCurdy, Michael T. Department of Emergency Medicine - University of Maryland School of Medicine, Baltimore, MD, USA
Abstract :
Cardiac dysfunction is a common complication of sepsis in individuals with preexisting coronary disease and portends a poor
prognosis when progressing to ischemic cardiogenic shock. In this setting, maximal medical therapy in isolation is often inadequate
to maintain cardiac output for patients who are poor candidates for immediate revascularization. Furthermore, the use of
vasopressors and inotropes increases myocardial demand and may lead to further injury. Percutaneous ventricular assist devices
provide a viable option for management of severe shock with multiorgan failure. The Impella is one of several novel mechanical
support systems that can effectively augment cardiac output while reducing myocardial demand and serve as a bridge to recovery
from severe hemodynamic compromise. This case report describes the successful utilization of the Impella 2.5 in a patient with
baseline profound anemia and coronary artery disease (CAD) presenting in combined distributive and cardiogenic shock associated
with a type 2 myocardial infarction complicating sepsis.
Keywords :
Augmenting Function , Infarction , Infection , Sepsis , Ischemic Cardiogenic , Shock Complicating
