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Review
. 2024 Mar 30;14(1):45.
doi: 10.1186/s13613-024-01260-y.

Management of cardiogenic shock: a narrative review

Driss Laghlam  1 , Sarah Benghanem  2   3   4 , Sofia Ortuno  5   6 , Nadia Bouabdallaoui  7 , Stephane Manzo-Silberman  6   8 , Olfa Hamzaoui  9   10 , Nadia Aissaoui  2   3   4
Affiliations
Review

Management of cardiogenic shock: a narrative review

Driss Laghlam et al. Ann Intensive Care. .

Abstract

Cardiogenic shock (CS) is characterized by low cardiac output and sustained tissue hypoperfusion that may result in end-organ dysfunction and death. CS is associated with high short-term mortality, and its management remains challenging despite recent advances in therapeutic options. Timely diagnosis and multidisciplinary team-based management have demonstrated favourable effects on outcomes. We aimed to review evidence-based practices for managing patients with ischemic and non-ischemic CS, detailing the multi-organ supports needed in this critically ill patient population.

Keywords: Cardiogenic shock; ECMO; Hemodynamic monitoring; Mechanical ventilation; Myocardial infarction; Shock.

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Conflict of interest statement

Manzo-Silberman S has received consulting fees from Bayer, Organon, Exeltis, lecture fees from Bayer, BMS, Exeltis and Organon, has served in the adjudication board for a study for Biotronik. Hamzaoui O has received lecture fees from BAXTER. Laghlam D, Benghanem S, Ortuno S Bouabdallaoui N and Aissaoui N have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Classifications of cardiogenic shock. A SCAI classification. B Phenotypic classification: Three different phenotypes are proposed (I-Not congested, II-cardiorenal, and III-cardiometabolic). C Hemodynamic classification: CI, cardiac index; PCWP, pulmonary capillary wedge pressure; and SVRI, systemic vascular resistance index
Fig. 2
Fig. 2
Assessment and diagnosis algorithm for CS early management. Abbreviations: BiV, biventricular dysfunction; CI, cardiac index; CS, cardiogenic shock; ECG, electrocardiogram; LV, left ventricular; RV, right ventricular; SBP, systolic blood pressure
Fig. 3
Fig. 3
Cardiogenic shock management. Abbreviations: AV ECMO, arteriovenous extracorporeal membrane oxygenation; HR, heart rate; LV, left ventricular; RV, right ventricular
See this image and copyright information in PMC

References

    1. Aissaoui N, Puymirat E, Delmas C, Ortuno S, Durand E, Bataille V, et al. Trends in cardiogenic shock complicating acute myocardial infarction. Eur J Heart Fail. 2020;22(4):664–672. - PubMed
    1. Arrigo M, Price S, Baran DA, Pöss J, Aissaoui N, Bayes-Genis A, et al. Optimising clinical trials in acute myocardial infarction complicated by cardiogenic shock: a statement from the 2020 Critical Care Clinical Trialists Workshop. Lancet Respir Med. 2021;9(10):1192–1202. - PubMed
    1. Baran DA, Grines CL, Bailey S, Burkhoff D, Hall SA, Henry TD, et al. SCAI clinical expert consensus statement on the classification of cardiogenic shock: This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019. Catheter Cardiovasc Interv. 2019;94(1):29–37. - PubMed
    1. Jentzer JC, van Diepen S, Barsness GW, Henry TD, Menon V, Rihal CS, et al. Cardiogenic shock classification to predict mortality in the cardiac intensive care unit. J Am Coll Cardiol. 2019;74(17):2117–2128. - PubMed
    1. van Diepen S, Katz JN, Albert NM, Henry TD, Jacobs AK, Kapur NK, et al. Contemporary management of cardiogenic shock: a scientific statement from the American heart association. Circulation. 2017;136(16):e232–e268. - PubMed

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