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心源性休克与临时机械循环支持

Cardiogenic Shock and Temporary Mechanical Circulatory Support.

作者信息

Khalif Adnan, DuMont Tiffany, Ranganathan Karthikeyan

机构信息

Department of Interventional Cardiology, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania (Drs Khalif and Ranganathan) and Division of Pulmonary Critical Care Medicine, School of Nursing, Ryerson University, Toronto, Ontario, Canada (Dr DuMont).

出版信息

Crit Care Nurs Q. 2022;45(3):218-224. doi: 10.1097/CNQ.0000000000000406.

Abstract

Cardiogenic shock is a state of circulatory collapse due to low cardiac output resulting from heart failure. Heart failure in this setting may be due to left, right, or biventricular dysfunction. Acute myocardial infarctions remain the most common cause of cardiogenic shock, although in contemporary patient populations, the increasing prevalence of end-stage heart failure has resulted in a growing population of heart failure cardiogenic shock presentations. Clinicians practicing in the cardiac intensive care unit are challenged with these increasingly complex patients. Such patients often require hemodynamic support to improve end-organ perfusion and reduce mortality. Mechanical devices, collectively known as temporary mechanical circulatory support, provide clinicians with additional tools in our armamentarium to combat the increased mortality associated with cardiogenic shock. In this article, we provide an overview of cardiogenic shock and its phenotypic clinical presentations, in addition to providing a description of temporary mechanical circulatory support devices that are currently utilized in the management of cardiogenic shock.

摘要

心源性休克是一种由于心力衰竭导致心输出量降低而引起的循环衰竭状态。在此情况下,心力衰竭可能是由于左心室、右心室或双心室功能障碍所致。急性心肌梗死仍然是心源性休克最常见的原因,尽管在当代患者群体中,终末期心力衰竭患病率的增加导致了心力衰竭心源性休克表现的患者群体不断扩大。在心脏重症监护病房工作的临床医生面临着这些日益复杂的患者的挑战。这类患者通常需要血流动力学支持以改善终末器官灌注并降低死亡率。统称为临时机械循环支持的机械设备为临床医生提供了更多工具,以应对与心源性休克相关的死亡率增加问题。在本文中,我们除了描述目前用于心源性休克管理的临时机械循环支持设备外,还将概述心源性休克及其表型临床表现。

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