Obradovic Danilo, Freund Anne, Desch Steffen, Thiele Holger
Dtsch Med Wochenschr. 2020 May;145(9):624-632. doi: 10.1055/a-1106-3325. Epub 2020 Apr 29.
In patients admitted with acute myocardial infarction, cardiogenic shock remains the most common cause of death. Multidisciplinary care in a specialized center and guideline-compliant treatment of cardiogenic shock are crucial for the survival and prognosis of affected patients. Hemodynamic monitoring and stabilization by volume expansion, vasopressors and inotropes represent initial steps in the management of patients with cardiogenic shock. Nevertheless, early revascularization of the culprit-lesion is proved to be the most important treatment modality. Although the use of active mechanical circulatory support appears to be a promising therapeutic concept to improve clinical outcome in patients with infarct-related cardiogenic shock, in the few previous randomized trials mechanical circulatory support failed to show beneficial effects on short-term and long-term survival.
在因急性心肌梗死入院的患者中，心源性休克仍然是最常见的死亡原因。在专业中心进行多学科护理以及对心源性休克进行符合指南的治疗对于受影响患者的生存和预后至关重要。通过扩容、血管升压药和正性肌力药物进行血流动力学监测和稳定是心源性休克患者管理的初始步骤。然而，对罪犯病变进行早期血运重建被证明是最重要的治疗方式。尽管使用主动机械循环支持似乎是改善梗死相关心源性休克患者临床结局的一个有前景的治疗理念，但在之前为数不多的随机试验中，机械循环支持未能显示出对短期和长期生存的有益影响。
