What is the role of mechanical circulatory support in mixed cardiogenic vasodilatory shock?

To structure management for any individual patient with "mixed" shock, it is prerequisite to define the nature, sequence and contributors to the admixture of circulatory derangements.

Temporary mechanical circulatory support (tMCS) provides hemodynamic value for patients with a critical insufficiency of cardiac output in spite of prevailing circumstances of preload, afterload and metabolic demands. This can include some cardiogenic shock patients with a coexisting layer of pathologic vasodilatation, which is often dynamic. Management of this concurrent pathophysiology of vasoplegia may obligate interventions separate from tMCS, such as vasopressors or corrections of volume status.

For the patient with a severely compromised heart, tMCS can...