Nursing Management of Cardiogenic Shock Patients With Mechanical Circulatory Support: A Scoping Review.

Simone Amato, Francesco Gravante, Andrea Battisti, Antonio Cartolano, Francesca Soro, Emanuele Buccione, Hamilton Dollaku, Alessio Lo Cascio, Daniele Napolitano, Francesco Limonti, Anna Rita Marucci, Guglielmo Imbriaco

Journal: Nursing in critical care 2025;30(6):e70212

PMID: 41194457

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Abstract

BACKGROUND

Despite limited evidence on nursing interventions for cardiogenic shock (CS) patients with mechanical circulatory support (MCS), nurses play a key role in ensuring device function, monitoring and preventing complications.

AIM

This scoping review aimed to map the nursing role in patients with CS supported by MCS, including extracorporeal membrane oxygenation (ECMO).

STUDY DESIGN

A comprehensive search was conducted in PubMed, CINAHL, Scopus and Web of Science from database inception to May 2025. Eligible sources included primary studies and relevant grey literature reporting nursing care for patients treated with MCS. Eligible studies focused on adult individuals with CS receiving MCS and explored nursing aspects within intensive or critical care environments.

RESULTS

Ten studies met the inclusion criteria, encompassing various geographic and clinical contexts. Thematic analysis identified four primary domains of nursing intervention: (1) continuous monitoring of haemodynamic and device-specific parameters; (2) complication prevention and management, including haemorrhage, thromboembolism, and infection; (3) delivery of supportive care such as sedation, ventilation, nutrition and fluid balance; and (4) application of protocol-guided care to standardise interventions and ensure safety CONCLUSIONS: Nurses play an essential role in managing patients with CS supported by MCS, with critical contributions across all phases of care. However, variability in practice and lack of standardised models persist.

RELEVANCE TO CLINICAL PRACTICE

Reinforcing nurse training, using evidence-based protocols and ensuring adequate staffing are key to improving care quality, while structured competencies and standardised documentation enhance continuity and patient safety.

Address: Cardiac Intensive Care Unit, Heart Transplant Centre and ECMO Service, San Camillo Forlanini Hospital, Rome, Italy.; Intensive Care Unit, Department of Critical Care, Local Health Authority of Caserta, Caserta, Italy.; Cardiovascular Perfusion Unit, Department of Cardiac Surgery and Heart Transplantation, San Camillo Hospital, Rome, Italy.; Emergency and Critical Care Department, Umberto I University Hospital, Rome, Italy.; Department of Neurosurgery, San Camillo Forlanini Hospital, Rome, Italy.; Paediatric Intensive Care Unit, Local Health Authority No. 3 of Pescara, Pescara, Italy.; Department of Rehabilitation, IRCCS Don Carlo Gnocchi Foundation-ONLUS, Florence, Italy.; Supportive and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy.; Centre for Digestive Diseases (CEMAD), Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Department of Biomedicine and Prevention, University of Rome tor Vergata, Rome, Italy.; Cardio-Toraco Vascular Department, A.O.U. Sant'anna, Ferrara, Italy.; Department of Health Professions, San Camillo Forlanini Hospital, Rome, Italy.; Emergency Medical Communication and Prehospital Emergency Service (118 Emilia Est), Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.

DOI: 10.1111/nicc.70212

MeSH Terms: Humans, Shock, Cardiogenic, Extracorporeal Membrane Oxygenation, Critical Care Nursing, Nurse's Role