Use of Levosimendan in ICU Settings

Use of Levosimendan in ICU Settings

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

Management of Peripheral Venoarterial ECMO in 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

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

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

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

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 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

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

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

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

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

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

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

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