The medical treatment of cardiogenic shock

Med Intensiva (Engl Ed). 2024 Aug;48(8):477-486. doi: 10.1016/j.medine.2024.05.012. Epub 2024 Jun 3.

Abstract

Cardiogenic shock is characterized by tissue hypoperfusion due to the inadequate cardiac output to maintain the tissue oxygen demand. Despite some advances in cardiogenic shock management, extremely high mortality is still associated with this clinical syndrome. Its management is based on the immediate stabilization of hemodynamic parameters through medical care and the use of mechanical circulatory supports in specialized centers. This review aims to understand the cardiogenic shock current medical treatment, consisting mainly of inotropic drugs, vasopressors and coronary revascularization. In addition, we highlight the relevance of applying measures to other organ levels based on the optimization of mechanical ventilation and the appropriate initiation of renal replacement therapy.

Keywords: Cardiogenic shock; Coronary revascularization; Inotropic therapy; Mechanical ventilation; Medical treatment; Revascularización coronaria; Shock cardiogénico; Tratamiento inotrópico; Tratamiento médico; Vasopresores; Vasopressors; Ventilación mecánica.

Publication types

  • Review

MeSH terms

  • Cardiotonic Agents* / therapeutic use
  • Extracorporeal Membrane Oxygenation
  • Hemodynamics
  • Humans
  • Myocardial Revascularization
  • Renal Replacement Therapy / methods
  • Respiration, Artificial
  • Shock, Cardiogenic* / etiology
  • Shock, Cardiogenic* / therapy
  • Vasoconstrictor Agents* / therapeutic use

Substances

  • Cardiotonic Agents
  • Vasoconstrictor Agents