Ischaemic cardiogenic shock. Issue 3 (March 2020)

• Record Type: Journal Article
• Authors: Jones, Carys; Burrell, Aidan
• Is Part Of: Anaesthesia and intensive care medicine. Volume 21:Issue 3(2020)
• Page Start: 133
• Page End: 138
• Publication Date: 2020-03
• Subjects: Acute myocardial infarction -- cardiogenic shock -- mechanical circulatory support -- myocardial revascularization; Anesthesiology -- Periodicals; Critical care medicine -- Periodicals; Anesthesia -- Periodicals; Intensive care -- Periodicals; Electronic journals; Periodicals; 617.9605
• DOI: 10.1016/j.mpaic.2020.01.002
• Languages: English
• ISSNs: 1472-0299

Abstract

Abstract: The recognition of cardiogenic shock in the setting of myocardial ischaemia has important prognostic and therapeutic implications. Resuscitative efforts should focus on stabilizing circulatory and respiratory function, with early restoration of coronary blood flow to avoid multi-organ dysfunction and death. However, despite recent progress, the mortality rate remains high, in the order of 40–50%. This article highlights several key recent advances in the management of ischaemic cardiogenic shock, including the use of early bedside echocardiography to confirm the diagnosis, and culprit only lesion strategies of early revascularization. Furthermore, we appraise the variety of mechanical cardiac supports that are increasingly being used to assist the management of ischaemic cardiogenic shock in those cases refractory to pharmacological intervention.