Isseh Iyad N, Lee Ran, Khedraki Rola, Hoffman Karlee
Kaufman Center of Heart Failure Treatment and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue J3-4, Cleveland, OH 44195 USA.
Curr Treat Options Cardiovasc Med. 2021;23(5):29. doi: 10.1007/s11936-021-00903-8. Epub 2021 Mar 23.
Here, we review the importance of using hemodynamic data to guide therapy and risk stratification in cardiogenic shock as well as the various definitions of this syndrome that have been used in prior studies. Furthermore, we provide perspective regarding the controversy surrounding pulmonary artery (PA) catheter use as well as current society guidelines and scientific statements. Lastly, we review the technical aspects for accurate interpretation of data of cardiogenic shock.
More recent studies specifically evaluating cardiogenic shock patients have shown higher mortality when PA catheters were not used. Furthermore, initiatives are underway to develop more standardized definitions of cardiogenic shock, including the SCAI Shock Classification Scheme. Only by having a standardized fashion of conveying severity of shock will we be able to more systematically study this patient population and improve outcomes moving forward.
PA catheters are critical to the prognostication and management of a subset of patients with cardiopulmonary disease, particularly in those with pulmonary hypertension, cardiogenic shock, or requiring mechanical circulatory support or undergoing evaluation for advanced heart failure therapies.
在此，我们回顾利用血流动力学数据指导心源性休克治疗及风险分层的重要性，以及先前研究中使用的该综合征的各种定义。此外，我们针对围绕肺动脉导管使用的争议以及当前的社会指南和科学声明提供观点。最后，我们回顾准确解读心源性休克数据的技术方面。
近期专门评估心源性休克患者的研究表明，不使用肺动脉导管时死亡率更高。此外，正在开展相关举措以制定更标准化的心源性休克定义，包括美国心血管造影和介入学会（SCAI）休克分类方案。只有采用标准化方式来传达休克严重程度，我们才能更系统地研究这一患者群体并改善未来的治疗结果。
肺动脉导管对于一部分心肺疾病患者的预后评估和管理至关重要，特别是那些患有肺动脉高压、心源性休克，或需要机械循环支持，或正在接受晚期心力衰竭治疗评估的患者。
