PDF(Pubmed)
Abstract：
Cardiogenic shock (CS) is a time-sensitive and hemodynamically complex syndrome with a broad spectrum of etiologies and clinical presentations. Despite contemporary therapies, CS continues to maintain high morbidity and mortality ranging from 35 to 50%. More recently, burgeoning observational research in this field aimed at enhancing the early recognition and characterization of the shock state through standardized team-based protocols, comprehensive hemodynamic profiling, and tailored and selective utilization of temporary mechanical circulatory support devices has been associated with improved outcomes. In this narrative review, we discuss the pathophysiology of CS, novel phenotypes, evolving definitions and staging systems, currently available pharmacologic and device-based therapies, standardized, team-based management protocols, and regionalized systems-of-care aimed at improving shock outcomes. We also explore opportunities for fertile investigation through randomized and non-randomized studies to address the prevailing knowledge gaps that will be critical to improving long-term outcomes.
摘要：
心源性休克（CS）是一种时间敏感且血液动力学复杂的综合征，具有广泛的病因和临床表现。尽管有当代疗法，CS继续保持35％至50％的高发病率和死亡率。最近,该领域的新兴观测研究旨在通过标准化的基于团队的协议来增强对休克状态的早期识别和表征，全面的血液动力学分析，定制和选择性地利用临时机械循环支持装置与改善的结果相关。在这篇叙述性评论中，我们讨论了CS的病理生理学，新的表型，不断演变的定义和暂存系统，目前可用的药物和基于设备的疗法，标准化，基于团队的管理协议，以及旨在改善休克结局的区域化医疗系统。我们还通过随机和非随机研究探索肥沃调查的机会，以解决普遍的知识差距，这对改善长期结果至关重要。
