Cardiogenic Shock

• Cardiogenic Shock includes decompensated HF shock and MI-shock.
  • HF-shock appears to derive more benefit from IABP than MI-shock
• CS is a common diagnosis among patients admitted to contemporary CICUs, prevalent in approximately 15% of total CICU admissions. ¹

Management

Pulmonary Artery Catheter (PAC)

• Hemodynamic tailoring with diuretics, vasoactive medications, and mechanical circulatory support (MCS) should be guided by both objective measures from the PAC, including a CVP target between 5-10 mm Hg, pulmonary artery wedge pressure generally ≤15 mm Hg, and cardiac index ≥2.2 L/min/m2, as well as markers of appropriate perfusion, such as lactate, mental status, and urine output.

IABP

See role of

Footnotes

1. Berg D.D., Bohula E.A., van Diepen S., et al. “Epidemiology of shock in contemporary cardiac intensive care units”. Circ Cardiovasc Qual Outcomes . 2019;12:e005618. ↩