Abstract:
Cardiogenic shock (CS) is a heterogeneous syndrome reflecting a broad spectrum of shock severity, diverse etiologies, variable cardiac function, different hemodynamic trajectories, and concomitant organ dysfunction. These factors influence the clinical presentation, management, response to therapy, and outcomes of CS patients, necessitating a tailored approach to care. To better understand the variability inherent to CS populations, recent algorithms for staging the severity of CS have been described and validated. This paper is part 1 of a 2-part state-of-the-art review. In this first article, we consider the context for clinical staging and stratification in CS with a focus on established severity staging systems for CS and their use for risk stratification and clinical care. We describe the use of staging for predicting outcomes in populations with or at risk for CS, including risk modifiers that provide more nuanced risk stratification, and highlight how these approaches may allow individualized care.
摘要:
心源性休克(CS)是一种异质性综合征,反映了广泛的休克严重程度,不同的病因,可变心功能,不同的血液动力学轨迹,和伴随的器官功能障碍。这些因素影响临床表现,管理,对治疗的反应,和CS患者的结果,需要一种量身定制的护理方法。为了更好地理解CS群体固有的变异性,已经描述并验证了对CS严重程度进行分期的最新算法。本文是由两部分组成的最新评论的第一部分。在这第一篇文章中,我们考虑了CS临床分期和分层的背景,重点是建立的CS严重程度分期系统及其在风险分层和临床护理中的应用.我们描述了分期在有CS或有CS风险的人群中预测结果的用途,包括提供更细微风险分层的风险修饰符,并强调这些方法如何允许个性化护理。