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心原性休克临时机械支持治疗指南:明智选择。

Guide to Temporary Mechanical Support in Cardiogenic Shock: Choosing Wisely.

机构信息

Robert and Suzanne Tomsich Department of Cardiology, Section of Heart Failure & Cardiac Transplant Medicine, Cleveland Clinic, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.

Robert and Suzanne Tomsich Department of Cardiology, Section of Heart Failure & Cardiac Transplant Medicine, Cleveland Clinic, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.

出版信息

Heart Fail Clin. 2024 Oct;20(4):445-454. doi: 10.1016/j.hfc.2024.06.010.

Abstract

Cardiogenic shock is a multisystem pathology that carries a high mortality rate, and initial pharmacotherapies include the use of vasopressors and inotropes. These agents can increase myocardial oxygen consumption and decrease tissue perfusion that can oftentimes result in a state of refractory cardiogenic shock for which temporary mechanical circulatory support can be considered. Numerous support devices are available, each with its own hemodynamic blueprint. Defining a patient's hemodynamic profile and understanding the phenotype of cardiogenic shock is important in device selection. Careful patient selection incorporating a multidisciplinary team approach should be utilized.

摘要

心原性休克是一种多系统疾病,死亡率很高,初始药物治疗包括使用血管加压素和正性肌力药。这些药物可以增加心肌耗氧量,减少组织灌注,这通常会导致难治性心原性休克,此时可以考虑使用临时机械循环支持。有许多支持设备可用,每种设备都有自己的血流动力学蓝图。在设备选择中,定义患者的血流动力学特征并了解心原性休克的表型很重要。应利用多学科团队方法进行仔细的患者选择。

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