Cardiogenic shock: evolving definitions and future directions in management

Autor: Tara L Jones, Kenta Nakamura, James M McCabe
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Open Heart, Vol 6, Iss 1 (2019)
Druh dokumentu: article
ISSN: 2053-3624
DOI: 10.1136/openhrt-2018-000960
Popis: Cardiogenic shock (CS) is a complex and highly morbid entity conceptualised as a vicious cycle of injury, cardiac and systemic decompensation, and further injury and decompensation. The pathophysiology of CS is incompletely understood but limited clinical trial experience suggests that early and robust support of the failing heart to allow for restoration of systemic homoeostasis appears critical for survival. We review the pathophysiology, clinical features and trial data to construct a contemporary model of CS as a systemic process characterised with maladaptive compensatory mechanisms requiring prompt and appropriately tailored medical and mechanical support for optimal outcomes. We conclude with an algorithmic approach to acute CS incorporating clinical and haemodynamic data to match the patient’s cardiac and systemic needs as a template for contemporary management.
Databáze: Directory of Open Access Journals