Sandbox: Cardiogenic Shock
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 De nitions 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 |