Pan-London Intensive Care Medicine Training Programme, London, UK.
Perioperative Medicine Department, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Br J Hosp Med (Lond). 2023 Jul 2;84(7):1-8. doi: 10.12968/hmed.2023.0139. Epub 2023 Jul 18.
Cardiogenic shock remains a time-critical, complex syndrome that continues to present challenges to clinicians and healthcare systems. Despite advances in the fields of cardiovascular and critical care medicine, mortality remains high. This article summarises the recent shock to survival document, which outlined the current and ideal future state of cardiogenic shock care nationally to improve patient outcomes. Shock to survival emphasises the need for education and training in the early recognition of the hypoperfusion that is pathognomomic of cardiogenic shock. Improved provision of focused cardiac ultrasound is essential to confirm a cardiac cause. Early identification of the patient with cardiogenic shock should be supported by access to defined pathways of care, including specialist shock centres and multiprofessional teams with domain expertise and the capability to manage the myriad of causative aetiologies. Given the absence of high-quality data to inform practice nationally, robust datasets are an unmet need to inform best practice, guide design of clinical services and pathways and drive innovation through research and clinical trials.
心原性休克仍然是一种时间紧迫的复杂综合征，它继续给临床医生和医疗保健系统带来挑战。尽管心血管和重症监护医学领域取得了进展，但死亡率仍然很高。本文总结了最近的休克生存文件，该文件概述了全国范围内心原性休克护理的现状和理想的未来状态，以改善患者的预后。休克生存强调了在早期识别心原性休克特有的低灌注方面进行教育和培训的必要性。改善重点心脏超声的提供对于确认心脏原因至关重要。心原性休克患者的早期识别应通过获得明确的护理途径来支持，包括专科休克中心和多专业团队，这些团队具有专业知识和管理众多病因的能力。鉴于全国范围内缺乏高质量的数据来指导实践，因此需要强有力的数据集来提供最佳实践信息，指导临床服务和途径的设计，并通过研究和临床试验推动创新。
