The medical treatment of cardiogenic shock

Mickael Lescroart; Benjamin Pequignot; Dany Janah; Bruno Levy

doi:10.1016/j.jointm.2022.12.001

The medical treatment of cardiogenic shock

J Intensive Med. 2023 Jan 19;3(2):114-123. doi: 10.1016/j.jointm.2022.12.001. eCollection 2023 Apr 30.

Authors

Mickael Lescroart^{1

2

3}, Benjamin Pequignot^{1

2

3}, Dany Janah^{1

2

3}, Bruno Levy^{1

2

3}

Affiliations

¹ Service de Médecine Intensive et Réanimation Brabois, CHRU Nancy, Pôle Cardio-Médico-Chirurgical, Vandoeuvre-les-Nancy 54511, France.
² INSERM U1116, Faculté de Médecine, Vandoeuvre-les-Nancy 54511, France.
³ Université de Lorraine, Vandoeuvre-les-Nancy 54000, France.

Abstract

Cardiogenic shock (CS) is a leading cause of mortality worldwide. CS presentation and management in the current era have been widely depicted in epidemiological studies. Its treatment is codified and relies on medical care and extracorporeal life support (ECLS) in the bridge to recovery, chronic mechanical device therapy, or transplantation. Recent improvements have changed the landscape of CS. The present analysis aims to review current medical treatments of CS in light of recent literature, including addressing excitation-contraction coupling and specific physiology on applied hemodynamics. Inotropism, vasopressor use, and immunomodulation are discussed as pre-clinical and clinical studies have focused on new therapeutic options to improve patient outcomes. Certain underlying conditions of CS, such as hypertrophic or Takotsubo cardiomyopathy, warrant specifically tailored management that will be overviewed in this review.

Keywords: Cardiogenic shock; Epidemiology; Etiology; Medical treatment; Monitoring.

Publication types

Review