Cormican Daniel S, Sonny Abraham, Crowley Jerome, Sheu Richard, Sun Terri, Gibson Christina M, Núñez-Gil Iván J, Ramakrishna Harish
Department of Anesthesiology, Divisions of Cardiothoracic Anesthesiology and Critical Care Medicine, Allegheny Health Network, Pittsburgh, PA.
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA.
J Cardiothorac Vasc Anesth. 2021 Oct;35(10):3098-3104. doi: 10.1053/j.jvca.2020.10.062. Epub 2020 Nov 5.
Effective management of cardiogenic shock (CS) is hampered by a lack of evidence-based information. This is a high-mortality condition, without clear, evidence-based guidelines for perioperative management, specifically-a lack of target endpoints for treatment (e.g.: mean arterial pressure or oxygenation), utility of regional care systems or the benefits of palliative care. The Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC) recently published a position statement that aimed to offer contemporary guidance on the diagnosis and treatment of acute myocardial infarction (AMI) complicated by CS. Herein, we review this complex clinical topic and review the ACCA statement on AMI associated with CS, with a focus on relevance to perioperative management.
缺乏循证信息阻碍了心源性休克（CS）的有效管理。这是一种高死亡率的病症，缺乏关于围手术期管理的明确循证指南，特别是缺乏治疗的目标终点（例如：平均动脉压或氧合）、区域护理系统的效用或姑息治疗的益处。欧洲心脏病学会（ESC）急性心血管护理协会（ACCA）最近发表了一份立场声明，旨在为并发CS的急性心肌梗死（AMI）的诊断和治疗提供当代指导。在此，我们回顾这一复杂的临床主题，并审视ACCA关于与CS相关的AMI的声明，重点关注其与围手术期管理的相关性。
