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重症监护病房心原性休克的心脏外治疗。

Extra-cardiac management of cardiogenic shock in the intensive care unit.

机构信息

Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Division of Cardiology, St Michael's Hospital, and Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Sections of Critical Care Cardiology and Advanced Heart Failure and Transplant Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio.

出版信息

J Heart Lung Transplant. 2024 Jul;43(7):1051-1058. doi: 10.1016/j.healun.2024.03.017.

Abstract

Cardiogenic shock (CS) is a heterogeneous clinical syndrome characterized by low cardiac output leading to end-organ hypoperfusion. Organ dysoxia ranging from transient organ injury to irreversible organ failure and death occurs across all CS etiologies but differing by incidence and type. Herein, we review the recognition and management of respiratory, renal and hepatic failure complicating CS. We also discuss unmet needs in the CS care pathway and future research priorities for generating evidence-based best practices for the management of extra-cardiac sequelae. The complexity of CS admitted to the contemporary cardiac intensive care unit demands a workforce skilled to care for these extra-cardiac critical illness complications with an appreciation for how cardio-systemic interactions influence critical illness outcomes in afflicted patients.

摘要

心原性休克(CS)是一种以心输出量降低导致终末器官灌注不足为特征的异质性临床综合征。所有 CS 病因都存在器官低氧血症,从短暂的器官损伤到不可逆的器官衰竭和死亡,但发病和类型不同。在此,我们回顾了 CS 合并呼吸、肾和肝功能衰竭的识别和处理。我们还讨论了 CS 治疗途径中未满足的需求以及未来研究重点,以制定基于循证的最佳实践,用于管理心脏外后遗症。当代心脏重症监护病房收治的 CS 病情复杂,需要一支熟练的医疗团队来护理这些心脏外危重病并发症,并了解心-全身相互作用如何影响患病患者的危重病结局。

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