The aim was to translationally compare a pharmacologic strategy versus treatment with the Impella RP in profound RV cardiogenic shock (CS). The pigs were allocated to either vasoactive therapy with norepinephrine (0.10 μg/kg/min) for the first 30 min, supplemented by an infusion of milrinone (0.4 μg/kg/min) for additional 150 min, or treatment with the Impella RP device for 180 min. Total RV workload (Pressure-volume-area × heart rate*10³(mmHg/min)) remained unaffected upon treatment with the Impella RP and increased in the vasoactive group (CS 179[147;228] to norepinephrine 268[247;306](p = 0.002 compared to Impella RP) and norepinephrine + milrinone 366[329;422] (p = 0.002 compared to Impella RP). A trend towards higher venous cerebral oxygen saturation was observed with norepinephrine than Impella RP (Impella RP 51[47;61]% vs norepinephrine 62[57;71]%; p = 0.07), which became significantly higher with the addition of milrinone (Impella RP 45[32;63]% vs norepinephrine + milrinone 73[66;81]%; p = 0.002). The Impella RP unloaded the failing RV. In contrast, vasoactive treatment led to enhanced cerebral venous oxygen saturation.

目的是在深度 RV 心源性休克 (CS) 中比较药理学策略与 Impella RP 治疗。猪被分配到前 30 分钟用去甲肾上腺素 (0.10 μg/kg/min) 进行血管活性治疗，然后再输注米力农 (0.4 μg/kg/min) 150 分钟，或用 Impella RP 装置治疗180 分钟。总 RV 工作量（压力-体积-面积 × 心率*10 ³ (mmHg/min)）在 Impella RP 治疗后仍然不受影响，并且在血管活性组中增加（CS 179[147;228] 至去甲肾上腺素 268[247;306 ]（与 Impella RP 相比p = 0.002）和去甲肾上腺素 + 米力农 366[329;422] ( p= 0.002 与 Impella RP 相比）。与 Impella RP 相比，去甲肾上腺素观察到静脉脑氧饱和度更高的趋势（Impella RP 51[47;61]% vs 去甲肾上腺素 62[57;71]%；p = 0.07），加入米力农后显着升高（ Impella RP 45[32;63]% vs 去甲肾上腺素 + 米力农 73[66;81]%；p = 0.002）。Impella RP 卸载了故障的 RV。相比之下，血管活性药物治疗导致脑静脉血氧饱和度增加。