Khariton Yevgeniy, Hassan Ossama Abou, Hernandez-Montfort Jaime A
Baylor Scott and White Health - Temple, Texas, USA.
Curr Opin Cardiol. 2023 Mar 1;38(2):108-115. doi: 10.1097/HCO.0000000000001017. Epub 2023 Jan 16.
The following review is intended to provide a summary of contemporary cardiogenic shock (CS) profiling and diagnostic strategies, including biomarker and hemodynamic-based (invasive and noninvasive) monitoring, discuss clinical differences in presentation and trajectory between acute myocardial infarction (AMI)-CS and heart failure (HF)-CS, describe transitions to native heart recovery and heart replacement therapies with a focus on tailored management and emerging real-world data, and emphasize trends in team-based initiatives and interventions for cardiogenic shock including the integration of protocol-driven care.
This document provides a broad overview of contemporary scientific consensus statements as well as data derived from randomized controlled clinical trials and observational registry working groups focused on cardiogenic shock management.
This review highlights the increasingly important role of pulmonary artery catheterization in AMI-CS and HF-CS cardiogenic shock and advocates for routine application of algorithmic approaches with interdisciplinary care pathways. Cardiogenic shock algorithms facilitate the integration of clinical, hemodynamic, and imaging data to determine the most appropriate patient hemodynamic support platform to achieve adequate organ perfusion and decongestion.
以下综述旨在总结当代心源性休克(CS)的特征分析和诊断策略,包括基于生物标志物和血流动力学(有创和无创)的监测,讨论急性心肌梗死(AMI)-CS和心力衰竭(HF)-CS在临床表现和病程上的差异,描述向心脏自主恢复和心脏替代治疗的转变,重点关注个性化管理和新出现的真实世界数据,并强调基于团队的心源性休克治疗措施和干预的趋势,包括协议驱动治疗的整合。
本文对当代科学共识声明以及来自专注于心源性休克管理的随机对照临床试验和观察性注册工作组的数据进行了广泛概述。
本综述强调了肺动脉导管插入术在AMI-CS和HF-CS心源性休克中日益重要的作用,并提倡将算法方法与跨学科护理路径常规应用。心源性休克算法有助于整合临床、血流动力学和影像学数据,以确定最合适的患者血流动力学支持平台,以实现充分的器官灌注和减轻充血。