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[心源性休克:从早期诊断到多参数监测]

[Cardiogenic shock: from early diagnosis to multiparameter monitoring].

作者信息

Marini Marco, Battistoni Ilaria, Lavorgna Alberto, Vagnarelli Fabio, Lucà Fabiana, Biscottini Emilia, Caretta Giorgio, Procaccini Vincenza, Riva Letizia, Vianello Gabriele, Mortara Andrea, Pini Daniela, De Maria Renata, Aspromonte Nadia, Di Lenarda Andrea, Gulizia Michele Massimo, Valente Serafina

机构信息

S.O.D. Cardiologia-Emodinamica-UTIC, Dipartimento di Scienze Cardiovascolari, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona - Area Giovani ANMCO.

U.O.C. Cardiologia-UTIC, Dipartimento Cardiovascolare, P.O. "G. Mazzini", Teramo - Area Giovani ANMCO.

出版信息

G Ital Cardiol (Rome). 2017 Oct;18(10):696-707. doi: 10.1714/2790.28259.

Abstract

Cardiogenic shock (CS) is a life-threatening condition that occurs in response to reduced cardiac output, in the presence of adequate intravascular volume, and results in tissue hypoxia. CS can occur as a result of several etiologies but the most common is acute myocardial infarction. Despite the introduction of emergency revascularization for CS complicating acute myocardial infarction, mortality still remains exceptionally high, particularly in patients with refractory CS. The diagnosis of CS is sometimes challenging and it is based on clinical, hemodynamic, and biochemical signs. A multidisciplinary technical platform as well as specialized and experienced medical teams are crucial to treat this group of patients.We briefly summarize the main aspects of diagnosis, etiology and pathophysiology with a particular focus on macro- and microhemodynamic parameters that are essential for the diagnosis and treatment of this patient population.

摘要

心源性休克(CS)是一种危及生命的状况,发生于血管内容量充足的情况下心输出量降低,并导致组织缺氧。CS可由多种病因引起,但最常见的是急性心肌梗死。尽管针对并发急性心肌梗死的心源性休克引入了紧急血运重建治疗,但死亡率仍然极高,尤其是在难治性CS患者中。CS的诊断有时具有挑战性,它基于临床、血流动力学和生化指标。多学科技术平台以及专业且经验丰富的医疗团队对于治疗这类患者至关重要。我们简要总结诊断、病因和病理生理学的主要方面,特别关注对于该患者群体的诊断和治疗至关重要的宏观和微观血流动力学参数。

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