Schemmelmann Mara, Kelm Malte, Jung Christian
Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstrasse 5, Duesseldorf D-40225, Germany.
CARID, Cardiovascular Research Institute Duesseldorf, Duesseldorf 40225, Germany.
Eur Heart J Acute Cardiovasc Care. 2024 Dec 3;13(11):802-809. doi: 10.1093/ehjacc/zuae124.
Cardiogenic shock is a life-threatening condition characterized by inadequate cardiac output, leading to end-organ hypoperfusion and associated mortality rates ranging between 40 and 50%. The critical role of microcirculatory impairments in the progression of organ failure during shock has been highlighted in several studies. Traditional therapies have often focused on stabilizing macrocirculation, neglecting microcirculatory dysfunction, which can result in persistent tissue hypoxia and poor outcomes. This review highlights the importance of assessing microcirculation in cardiogenic shock, including parameters such as skin perfusion, sublingual microcirculation, and lactate dynamics. Integrating microcirculatory assessments into clinical practice remains challenging due to the complexity of the methods and limited therapeutic options targeting microvascular perfusion. While advances in microcirculation-guided therapies hold promise for improving outcomes in cardiogenic shock, further research is needed to establish effective protocols.
心源性休克是一种危及生命的病症，其特征为心输出量不足，导致终末器官灌注不足，相关死亡率在40%至50%之间。多项研究强调了微循环障碍在休克期间器官衰竭进展中的关键作用。传统疗法往往侧重于稳定大循环，而忽视了微循环功能障碍，这可能导致持续性组织缺氧和不良预后。本综述强调了评估心源性休克中微循环的重要性，包括皮肤灌注、舌下微循环和乳酸动力学等参数。由于方法复杂且针对微血管灌注的治疗选择有限，将微循环评估纳入临床实践仍具有挑战性。虽然微循环导向治疗的进展有望改善心源性休克的预后，但仍需要进一步研究以建立有效的方案。
