The concept of vaECMO treatment alone might be a valuable alternative in selected patients with massive PE and cardiogenic shock, in whom thrombolytic therapy might not unload the RV fast enough. We present a case of a patient... Read More

Extracorporeal membrane oxygenation (ECMO) causes both thrombosis and bleeding. Major society guidelines recommend continuous, systemic anticoagulation to prevent thrombosis of the ECMO circuit, though this may be undesirable... Read More

This book is designed to offer the reader first-rate guidance on shock management in the real world. Comprehensive, evidence-based, and up-to-date instruction is provided on optimal care of patients with different types of... Read More

The severity of cardiogenic shock following asystolic cardiac arrest is dependent on the length of cardiac arrest prior to cardiopulmonary resuscitation and is mediated by myocardial stunning resulting from mitochondrial... Read More

In general, randomized clinical trials in CS are difficult to perform and only three randomized trials adequately powered to detect differences in clinical outcomes achieved completion of the required number of patients.... 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

Microcirculation is severely impaired in patients with refractory cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO). Inability to rapidly restore microcirculation during the first 24 hours,... Read More

Thyroid storm requiring ICU admission causes high in-ICU mortality. Multiple organ failure and early cardiogenic shock seem to markedly impact the prognosis, suggesting a prompt identification and an aggressive management.... Read More

We could center this discussion about the SCAI paper that came out (attached). A nice collaborative expert panel piece outlining a CS pyramid used quickly at the bedside in the ED, ICU, Cath Lab, etc to help us identify these... 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

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

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

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