[Treatment of cardiogenic shock due to right ventricular involvement].

Autor: Santos-Martínez LE; Secretaría de Salud, Instituto Nacional de Cardiología 'Ignacio Chávez', Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares. Ciudad de México, México., Jiménez-Rodríguez GM; Secretaría de Salud, Instituto Nacional de Cardiología 'Ignacio Chávez', Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares. Ciudad de México, México., Sánchez-Nieto J; Secretaría de Salud, Instituto Nacional de Cardiología 'Ignacio Chávez', Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares. Ciudad de México, México., Ortiz-Obregón S; Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Cardiología, Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares. Ciudad de México, México., Romero-Zertuche D; Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Cardiología, Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares. Ciudad de México, México., Moreno-Ruiz LA; Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Cardiología, Departamento de Cardiología. Ciudad de México, México.
Jazyk: Spanish; Castilian
Zdroj: Revista medica del Instituto Mexicano del Seguro Social [Rev Med Inst Mex Seguro Soc] 2023 Nov 06; Vol. 61 (6), pp. 849-856. Date of Electronic Publication: 2023 Nov 06.
DOI: 10.5281/zenodo.10064450
Abstrakt: The right ventricle is susceptible to changes in preload, afterload, and contractility. The answer is its dilation with dysfunction/acute failure; filling is limited to the left ventricle and cardiac output. Systemic venous congestion is retrograde to the right heart, it is involved in the genesis of cardiogenic shock due to right ventricle involvement. This form of shock is less well known than that which occurs due to left ventricular failure, therefore, treatment may differ. Once the primary treatment has been carried out, since no response is obtained, supportive treatment aimed at ventricular pathophysiology will be the next option. It is suggested to evaluate the preload for the reasoned indication of liquids, diuretics or even ultrafiltration. Restore or maintain heart rate and sinus rhythm, treat symptomatic bradycardia, arrhythmias that make patients unstable, use of temporary pacing or cardioversion procedures. Improving contractility and vasomotility, using vasopressors and inotropes, alone or in combination, the objective will be to improve right coronary perfusion pressure. Balance the effect of drugs and maneuvers on preload and/or afterload, such as mechanical ventilation, atrial septostomy and pulmonary vasodilators. And the increasing utility of mechanical support of the circulation that has become a useful tool to preserve/restore right heart function.
(Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)
Databáze: MEDLINE
Externí odkaz: