Cardiogenic Shock


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Early revascularization, vasopressors and inotropes, fluids, mechanical circulatory support MCS , and general intensive care measures are widely used for CS management. However, there is only limited evidence for any of the above treatment strategies except for revascularization and the relative ineffectiveness of intra-aortic balloon pumping. In general, patients with CS should best be treated at specialized tertiary CS care centers. Revascularization should be limited to the culprit lesion with possible staged revascularization of other lesions at a later time point based on contemporary evidence.

Circ Heart Fail, 2 , pp.

Cardiogenic Shock (Jessica Brown, MD)

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Cardiogenic shock - Wikipedia

Differential effects of milrinone and dobutamine on right ventricular preload, afterload and systolic performance in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol, 60 , pp. Givertz, C. Andreou, C. Conrad, et al. Direct myocardial effects of levosimendan in humans with left ventricular dysfunction: alteration of force-frequency and relaxation-frequency relationships. De Luca, W. Collucci, M. Nieminen, et al. Evidence-based use of levosimendan in different clinical settings. Eur Heart J, 27 , pp. Gheorghiade, J.

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Acute hemodynamics and clinical effects of levosimendan in patients with severe heart failure. Lilleberg, M. Laine, T. Palkama, et al. Duration of the haemodynamic action of a h infusion of levosimendan in patients with congestive heart failure. Eur J Heart Fail, 9 , pp. Packer, W.

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Cardiogenic Shock

Just, et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure the LIDO study : a randomised double-blind trial. Husebye, J. Eritsland, C. Levosimendan in acute heart failure following primary percutaneous coronary intervention treated acute ST-elevation myocardial infarction. Results from the LEAF trial: a randomized, placebo-controlled study. Eur J Heart Fail, 15 , pp. Silva-Cardoso, J. Ferreira, A. Oliveira-Soares, et al.

Effectiveness and safety of levosimendan in clinical practice. Rev Port Cardiol, 28 , pp. Samimi-Fard, M. Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty. Fuhrmann, A. Schmeisser, M.

Schulze, et al. Levosimendan is superior to enoximone in refractory cardiogenic shock complicating acute myocardial infarction. Crit Care Med, 36 , pp. Russ, R. Prondzinsky, J. Carter, et al. Right ventricular function in myocardial infarction complicated by cardiogenic shock: improvement with levosimendan. Ann Cardiol Angeiol Paris , 61 , pp. Hollenberg, T. Ahrens, D. Annane, et al. Practice parameters for hemodynamic support of sepsis in adult patients: update. Crit Care Med, 32 , pp. Steg, S. James, D. Atar, et al.

ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J, 33 , pp. Meyer, W. McGuire, S. Gottschling, et al. The role of vasopressin and terlipressin in catecholamine-resistant shock and cardio-circulatory arrest in children: review of the literature.

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Wenzel, A. Krismer, H. Arntz, et al. A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation. Jolly, G. Newton, E. Horlick, et al. Effect of vasopressin on hemodynamics in patients with refractory cardiogenic shock complicating acute myocardial infarction. Argenziano, A. Choudhri, M. Oz, et al. A prospective randomized trial of arginine vasopressin in the treatment of vasodilatory shock after left ventricular assist device placement.

Circulation, 96 , pp. Guglin, M. Inotropes do not increase mortality in advanced heart failure. Int J Gen Med, 7 , pp. S Medline. Asfar, F. Meziani, J. Hamel, et al. High versus low blood pressure target in patients with septic shock. McMurray, S. Adamopoulos, S. Anker, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure Yancy, M. Jessup, B. Bozkurt, et al. Pei, P. Ma, J. Li, et al. Extensive variability in vasoactive agent therapy: a nationwide survey in Chinese intensive care units.

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Thiele, U. Zeymer, F-J. Neumann, et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. Rihal, S. Naidu, M. Givertz, et al. J Card Fail, 21 , pp. Werdan, S. Gielen, H. Ebelt, et al. Mechanical circulatory support in cardiogenic shock. Eur Heart J, 35 , pp. Berg, D. Sukul, M. Outcomes in patients undergoing percutaneous ventricular assist device implantation for cardiogenic shock. Santos, C.

Aguiar, C. Gavina, et al. Registo nacional de si?? Subscribe to our newsletter. Levosimendan: The current situation and new Cochrane Corner: Intra-aortic balloon pump in patients with Instructions for authors Submit an article Ethics in publishing. Article options. Are you a health professional able to prescribe or dispense drugs?

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V1 and V2 vasopressin receptor agonist. Levy et al. To compare hemodynamic effects, lactate metabolism and impact on systemic perfusion of epinephrine and combined dobutamine-norepinephrine. Epinephrine and norepinephrine-dobutamine had similar hemodynamic effects Epinephrine associated with transient increase in lactate level and HR, and inadequate gastric mucosa perfusion. Myburgh et al. ICU patients requiring norepinephrine or epinephrine. Time to achieve MAP goals and day mortality.

No differences in any endpoints. Annane et al. Efficacy and safety of norepinephrine plus dobutamine vs. Patients diagnosed with septic shock. Similar mortality in both groups. To compare hemodynamic effects of dopamine and dobutamine in patients with CS. Dobutamine increased stroke index and CI more than dopamine. To assess the efficacy of combined dobutamine and dopamine in CS. Elevation of troponin in CS may identify patients who present late. Arterial lactate is preferable since venous lactate is generally higher than arterial lactate and the 2. A low serum bicarbonate level is a better predictor of day mortality than the highest recorded lactate level.

A low B-type natriuretic peptide BNP level argues against CS in the setting of hypotension; however, an elevated BNP level does not establish the diagnosis, as any form of cardiac ventricular or atrial stress may elevate levels of this peptide. It is recommended to use a pulmonary artery catheter in the diagnosis and management of CS patients, along with rapidly transferring those requiring a higher level of care to an experienced shock center.

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