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心源性休克管理进展综述:从急救方案到长期治疗策略

Review of Advancements in Managing Cardiogenic Shock: From Emergency Care Protocols to Long-Term Therapeutic Strategies.

作者信息

Martínez León Amaia, Bazal Chacón Pablo, Herrador Galindo Lorena, Ugarriza Ortueta Julene, Plaza Martín María, Pastor Pueyo Pablo, Alonso Salinas Gonzalo Luis

机构信息

Cardiology Department, Hospital Universitario de Navarra (HUN-NOU), Calle de Irunlarrea, 3, 31008 Pamplona, Spain.

Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain.

出版信息

J Clin Med. 2024 Aug 16;13(16):4841. doi: 10.3390/jcm13164841.

Abstract

Cardiogenic shock (CS) is a complex multifactorial clinical syndrome of end-organ hypoperfusion that could be associated with multisystem organ failure, presenting a diverse range of causes and symptoms. Despite improving survival in recent years due to new advancements, CS still carries a high risk of severe morbidity and mortality. Recent research has focused on improving early detection and understanding of CS through standardized team approaches, detailed hemodynamic assessment, and selective use of temporary mechanical circulatory support devices, leading to better patient outcomes. This review examines CS pathophysiology, emerging classifications, current drug and device therapies, standardized team management strategies, and regionalized care systems aimed at optimizing shock outcomes. Furthermore, we identify gaps in knowledge and outline future research needs.

摘要

心源性休克(CS)是一种复杂的多因素临床综合征,表现为终末器官灌注不足,可能与多系统器官衰竭相关,其病因和症状多种多样。尽管近年来由于新进展生存率有所提高,但CS仍然具有严重发病和死亡的高风险。最近的研究集中在通过标准化团队方法、详细的血流动力学评估以及选择性使用临时机械循环支持装置来改善CS的早期检测和认识,从而使患者获得更好的预后。本综述探讨了CS的病理生理学、新出现的分类、当前的药物和器械治疗、标准化团队管理策略以及旨在优化休克治疗结果的区域化护理系统。此外,我们还确定了知识空白并概述了未来的研究需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2507/11355768/cb104dab73cc/jcm-13-04841-g001.jpg

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