Sandbox: Cardiogenic Shock: Difference between revisions
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CI of ≤2.2 L·min−1·m−2 AND PCWP ≥15 mmHg | CI of ≤2.2 L·min−1·m−2 AND PCWP ≥15 mmHg | ||
|| Clinical criteria: | || Clinical criteria: | ||
SBP <90 mmHg for ≥30 min OR Catecholamines to maintain SBP >90 mmHg AND | SBP <90 mmHg for ≥30 min OR Catecholamines to maintain SBP >90 mmHg AND | ||
Clinical pulmonary congestion | |||
AND | Clinical pulmonary congestion | ||
AND | |||
Impaired end-organ perfusion (altered mental status, cold/clammy skin and extremities, urine output <30 mL/h, or lactate >2.0 mmol/L) | Impaired end-organ perfusion (altered mental status, cold/clammy skin and extremities, urine output <30 mL/h, or lactate >2.0 mmol/L) | ||
|| SBP <90 mmHg with adequate volume and clinical or laboratory signs of hypoperfusion | || SBP <90 mmHg with adequate volume and clinical or laboratory signs of hypoperfusion | ||
Clinical hypoperfusion: | Clinical hypoperfusion: | ||
Cold extremities, oliguria, mental confusion, dizziness, narrow pulse pressure | Cold extremities, oliguria, mental confusion, dizziness, narrow pulse pressure | ||
Laboratory hypoperfusion: | Laboratory hypoperfusion: | ||
Metabolic acidosis, elevated serum lactate, elevated serum creatinine | Metabolic acidosis, elevated serum lactate, elevated serum creatinine | ||
|- | |- | ||
| colspan="4" | '''CI''' indicates cardiac index; '''CS''', cardiogenic shock; '''ESC''', European Society of Cardiology; HF, heart failure; '''IABP-SHOCK II''', Intraaortic Balloon Pump in Cardiogenic Shock II; '''LV''', left ventricular; '''MI''', myocardial infarction; '''PCWP''', pulmonary capillary wedge pressure; '''SBP''', systolic blood pressure; and '''SHOCK''', Should We Emergently Revascularize Occluded Coronaries for Cariogenic Shock | | colspan="4" | '''CI''' indicates cardiac index; '''CS''', cardiogenic shock; '''ESC''', European Society of Cardiology; HF, heart failure; '''IABP-SHOCK II''', Intraaortic Balloon Pump in Cardiogenic Shock II; '''LV''', left ventricular; '''MI''', myocardial infarction; '''PCWP''', pulmonary capillary wedge pressure; '''SBP''', systolic blood pressure; and '''SHOCK''', Should We Emergently Revascularize Occluded Coronaries for Cariogenic Shock | ||
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Revision as of 13:28, 3 November 2017
Template:Cardiogenic Shock - 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Arzu Kalayci, M.D. [2]
Contemporary Management of Cardiogenic Shock
Pragmatic and Clinical Trial Definitions of Cardiogenic Shock
| Clinical Definition | SHOCK Trial | IABP-SHOCK II | ESC HF Guidelines |
|---|---|---|---|
| Cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusion | Clinical criteria:
SBP <90 mmHg for ≥30 min OR Support to maintain SBP ≥90 mmHg AND End-organ hypoperfusion (urine output <30 mL/h or cool extremities) Hemodynamic criteria: CI of ≤2.2 L·min−1·m−2 AND PCWP ≥15 mmHg |
Clinical criteria:
SBP <90 mmHg for ≥30 min OR Catecholamines to maintain SBP >90 mmHg AND Clinical pulmonary congestion AND Impaired end-organ perfusion (altered mental status, cold/clammy skin and extremities, urine output <30 mL/h, or lactate >2.0 mmol/L) |
SBP <90 mmHg with adequate volume and clinical or laboratory signs of hypoperfusion
Clinical hypoperfusion: Cold extremities, oliguria, mental confusion, dizziness, narrow pulse pressure Laboratory hypoperfusion: Metabolic acidosis, elevated serum lactate, elevated serum creatinine |
| CI indicates cardiac index; CS, cardiogenic shock; ESC, European Society of Cardiology; HF, heart failure; IABP-SHOCK II, Intraaortic Balloon Pump in Cardiogenic Shock II; LV, left ventricular; MI, myocardial infarction; PCWP, pulmonary capillary wedge pressure; SBP, systolic blood pressure; and SHOCK, Should We Emergently Revascularize Occluded Coronaries for Cariogenic Shock | |||