Extracorporeal membrane oxygenation (ECMO) is a powerful mechanical circulatory support modality capable of rapidly restoring systemic perfusion yet lacking in defined approaches to management. Adopting a management approach... Read More

The parameter most frequently used to detect tissue malperfusion is serum lactate. Novel, noninvasive methods to quantify microvascular perfusion have the potential to guide treatment in terms of optimizing organ perfusion... Read More

Early epinephrine therapy within the first 24 h after cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO) was associated with poor survival compared to patients with or without any inodilator therapy.... Read More

Randomized, controlled trials are utterly needed to guide treatment with mechanical circulatory support for patients with cardiogenic shock. Importantly, such trials should focus patient selection criteria. In recent years,... Read More

Cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction although mortality could be reduced from formerly ∼80% to 40–50%. In addition to percutaneous coronary intervention... Read More

Vasopressors and inotropes are cornerstones in the management of shock syndromes. Understanding vasopressors’ receptor activity and resultant pharmacological response enables clinicians to select the ideal vasopressor(s)... Read More

In critically ill patients, effective arterial elastance may be reliably estimated at bedside. We support the use of this validated estimate of effective arterial elastance when coupled with an index of left ventricular contractility... Read More

Temporary circulatory support (TCS) have become the cornerstone of the management of patients with cardiogenic shock, although the evidence supporting their efficacy is limited. VA-ECMO is considered the first-line option,... Read More

Cardiogenic shock (CS) is a multifactorial and hemodynamically diverse high-acuity illness that is frequently associated with multisystem organ failure. The complexity of CS requires a widespread application of best-care... Read More

Levosimendan has been demonstrated to have potential utility in a range of critical illness scenarios. It must be acknowledged, however, that in each sphere of application, the evidence is incomplete or indicative rather... Read More

Tighter glucose control while minimizing the risk of severe hypoglycemia is associated with lower mortality among critically ill cardiac patents, new research suggests. Researchers reported in CHEST on the outcomes of a multicenter... Read More

This issue of Critical Care Clinics focuses on Mechanical Ventilation and Ventricular Assist Devices, with topics including: Targeted management approach to cardiogenic shock; Prevention and treatment of right heart failure... Read More

Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is widely used in cardiogenic shock. It provides systemic perfusion, but left ventricular (LV) unloading is suboptimal. Using a closed-loop, real-time computer model... Read More

Veno-arterial extracorporeal membrane oxygenation (va-ECMO) is increasingly and successfully used to assist patients with refractory cardiogenic shock from different causes. A total of 132 va-ECMO patients were enrolled.... Read More