Optimal Perfusion Targets in Cardiogenic Shock

被引:0
作者
Mathew, Rebecca [1 ,2 ]
Fernando, Shannon M. [3 ]
Hu, Kira [4 ]
Parlow, Simon [1 ,2 ,4 ]
Di Santo, Pietro [1 ,2 ,4 ]
Brodie, Daniel [5 ,6 ]
Hibbert, Benjamin [1 ,2 ,7 ]
机构
[1] Univ Ottawa, Div Cardiol, Ottawa, ON, Canada
[2] Univ Ottawa Heart Inst, CAPITAL Res Grp, Ottawa, ON, Canada
[3] Univ Ottawa, Dept Med, Div Crit Care, Ottawa, ON, Canada
[4] Univ Ottawa, Fac Med, Ottawa, ON, Canada
[5] Columbia Univ, Coll Phys & Surg, Div Pulm Allergy & Crit Care Med, New York, NY USA
[6] New York Presbyterian Hosp, Ctr Acute Resp Failure, New York, NY USA
[7] Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON, Canada
来源
JACC-ADVANCES | 2022年 / 1卷 / 02期
关键词
cardiogenic shock; lactate; mean arterial pressure; resuscitation; target; ACUTE MYOCARDIAL-INFARCTION; END-DIASTOLIC PRESSURE; PERCUTANEOUS CORONARY INTERVENTION; DECOMPENSATED HEART-FAILURE; VENOUS OXYGEN-SATURATION; IN-HOSPITAL MORTALITY; SHORT-TERM MORTALITY; ACUTE KIDNEY INJURY; BLOOD-PRESSURE; LACTATE CLEARANCE;
D O I
10.1016/j.jacadv.2022.100034
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cardiology shock is a syndrome of low cardiac output resulting in end-organ dysfunction. Few interventions have demonstrated meaningful clinical benefit, and cardiogenic shock continues to carry significant morbidity with mortality rates that have plateaued at upwards of 40% over the past decade. Clinicians must rely on clinical, biochemical, and hemodynamic parameters to guide resuscitation. Several features, including physical examination, renal function, serum lactate metabolism, venous oxygen saturation, and hemodynamic markers of right ventricular function, may be useful both as prognostic markers and to guide therapy. This article aims to review these targets, their utility in the care of patients with cardiology shock, and their association with outcomes. (JACC Adv 2022;1:100034) (c) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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页数:14
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