Purpose of Review

Mechanical circulatory support (MCS) devices have demonstrated improved survival outcomes in otherwise refractory cardiopulmonary failure but are associated with significant neurologic morbidity and mortality. This review aims to characterize MCS-associated brain injury and discuss the neurocritical care of this population.

Recent Findings

We found no practice guidelines or specific management strategies for the neurocritical care of patients with MCS devices. Acute brain injury was commonly observed in short-term and durable MCS devices. There is emerging evidence that a standardized neurological monitoring and management algorithm for MCS device–associated brain injury is feasible and potentially improves neurological outcomes.

Summary

While MCS devices are associated with significant neurologic morbidity and mortality, there is scant evidence regarding optimal neuromonitoring and neurocritical care. With the increase in use of MCS devices for both short-term and durable applications, improved outcomes will depend on early identification and intervention of neurologic complications and further research into their pathophysiology.

中文翻译：

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机械循环支持设备的神经重症监护

审查目的

机械循环支持（MCS）设备在其他难治性心肺功能衰竭中已显示出改善的生存结果，但与明显的神经系统疾病和死亡率相关。这项审查旨在表征与MCS相关的脑损伤，并讨论该人群的神经重症监护。

最近的发现

我们没有发现任何针对MCS设备患者的神经危重护理的实践指南或特定的管理策略。在短期和持久的MCS设备中通常会观察到急性脑损伤。越来越多的证据表明，针对MCS装置相关性脑损伤的标准化神经学监测和管理算法是可行的，并有可能改善神经学预后。

概括

尽管MCS设备与明显的神经系统疾病发病率和死亡率相关，但有关最佳神经监测和神经重症监护的证据很少。随着短期和长期使用MCS设备的增加，结果的改善将取决于神经系统并发症的早期发现和干预以及对它们的病理生理学的进一步研究。