A Targeted Management Approach to Cardiogenic Shock

Crit Care Clin. 2018 Jul;34(3):423-437. doi: 10.1016/j.ccc.2018.03.009.

Abstract

Cardiogenic shock is a clinical syndrome characterized by low cardiac output and sustained tissue hypoperfusion resulting in end-organ dysfunction and death. In-hospital mortality rates range from 50% to 60%. Urgent diagnosis, timely transfer to a tertiary or quaternary medical facility with critical care management capabilities and multidisciplinary shock teams is a must to increase survival. Aggressive, hemodynamically guided medical management with careful monitoring of clinical and hemodynamic parameters with timely use of appropriate mechanical circulatory support devices is often necessary. As treatment options evolve, prospective randomized controlled trials are needed to define best practices that define superior clinical outcomes.

Keywords: Cardiogenic shock; Coronary revascularization; Hemodynamics; Intraaortic balloon pump; Temporary mechanical support.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / therapy*
  • Cardiotonic Agents / therapeutic use
  • Coronary Artery Bypass
  • Extracorporeal Membrane Oxygenation
  • Heart-Assist Devices*
  • Humans
  • Intra-Aortic Balloon Pumping
  • Percutaneous Coronary Intervention
  • Risk Assessment
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / physiopathology
  • Shock, Cardiogenic / therapy*

Substances

  • Cardiotonic Agents