Shah Palak, Cowger Jennifer A
Inova Translational Medicine Institute, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
Heart Failure and Transplant Program, St Vincent Heart Center, 8333 Naab Road, Suite 400, Indianapolis, IN 46260, USA.
Crit Care Clin. 2014 Jul;30(3):391-412. doi: 10.1016/j.ccc.2014.03.001.
Cardiogenic shock is the most common cause of in-hospital mortality for patients who have suffered a myocardial infarction. Mortality exceeds 50% and management is focused on a rapid diagnosis of cardiogenic shock, restoration of coronary blood flow through early revascularization, complication management, and maintenance of end-organ homeostasis. Besides revascularization, inotropes and vasodilators are potent medical therapies to assist the failing heart. Pulmonary arterial catheters are an important adjunctive tool to assess patient hemodynamics, but their use should be limited to select patients in cardiogenic shock.
心源性休克是心肌梗死患者院内死亡的最常见原因。死亡率超过50%,治疗重点在于快速诊断心源性休克、通过早期血运重建恢复冠状动脉血流、处理并发症以及维持终末器官内环境稳定。除血运重建外,正性肌力药物和血管扩张剂是帮助衰竭心脏的有效药物治疗方法。肺动脉导管是评估患者血流动力学的重要辅助工具,但应仅限于选择性的心源性休克患者使用。