Cardioprotective shock management: monitoring and supportive therapies

Author:

Schibilsky David12,Delmas Clement3,Bonello Laurent4,Hunziker Patrick5

Affiliation:

1. Department of Cardiovascular Surgery, University Heartcenter Freiburg-Bad Krozingen, Hugstetter Str. 55, 79106 Freiburg, Germany

2. Faculty of Medicine, University Freiburg, Breisacher Str. 153, 79110 Freiburg, Germany

3. Intensive Cardiac Care Unit, Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France

4. Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix-Marseille University, 13015 Marseille, France

5. Intensive Care Unit, University Hospital Basel, University of Basel, Petersgraben 5, 4031 Basel, Switzerland

Abstract

Abstract Cardiogenic shock is a highly lethal syndrome, leading to rapid death or secondary multiorgan damage, but current shock therapies, including mechanical support devices, also have a significant side effect profile. The overarching goal of shock therapy is ensuring long-term survival with good quality of life. This implies averting death, modifying the disease course by promoting heart recovery and avoiding additional cardiac damage, protecting other organs, and circumventing complications. Monitoring and supportive therapies are subordinate to these goals. Rather than merely following preconceived notions, the rapid evolution in mechanical support technology requires iterative and critical review of the benefits of current procedures, protocols and drugs in view of their overall contribution to the therapeutic goals. This article discusses various monitoring and supportive pharmaceutical modalities typically used in patients with cardiogenic shock requiring mechanical support.

Funder

Abiomed Europe GmbH

Abiomed GmbH

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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