Tag: cardiogenic shock
Management of Peripheral Venoarterial ECMO in Cardiogenic Shock
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
Assessment of Microcirculation in Cardiogenic Shock
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
Epinephrine, Inodilator, or No Inotrope in VA-ECMO Implantation
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
Mechanical Circulatory Support Devices in Cardiogenic Shock and Acute Heart Failure
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
Management of Cardiogenic Shock
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 for Shock Syndromes
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
Validation and Critical Evaluation of the Effective Arterial Elastance in Critically Ill Patients
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
ECMO Use in Cardiogenic Shock
Increasing age is a well-recognized risk factor for in-hospital mortality in patients receiving extracorporeal membrane oxygenation (ECMO) for cardiogenic shock, but the shape of this relationship is unknown. Age is linearly... read more
Contemporary Management of Cardiogenic Shock
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
Mechanical Ventilation/Ventricular Assist Devices, An Issue of Critical Care Clinics
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
Left Ventricular Unloading During Veno-Arterial ECMO
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
Isolated Left Ventricular Failure is a Predictor of Poor Outcome in Patients Receiving Veno-Arterial ECMO
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
PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock
In patients who have acute myocardial infarction with cardiogenic shock, early revascularization of the culprit artery by means of percutaneous coronary intervention (PCI) improves outcomes. However, the majority of patients... read more
Deaths After PCI: Study Compares Public Reporting Models Both With and Without Cardiogenic Shock
Three distinct models for reporting risk-adjusted mortality rates among hospitals and physicians performing PCI in New York State demonstrate a high degree of agreement, despite variation in how they handle the inclusion... read more
Adrenomedullin: a marker of impaired hemodynamics in cardiogenic shock
Bio-ADM is a valuable prognosticator and marker of impaired hemodynamics in CS patients. High levels of bio-ADM may show shock refractoriness and developing end-organ dysfunction and thus help to guide therapeutic approach... read more
Impella CP Versus Intra-Aortic Balloon Pump in Acute Myocardial Infarction Complicated by Cardiogenic Shock
At 30 days, mortality in patients treated with either IABP or Impella CP was similar (50% and 46%, respectively, hazard ratio (HR) with Impella CP, 0.96 (95% confidence interval (CI) 0.42 to 2.18; p=0.92).... read more
