New modalities for increasing tissue perfusion in cardiogenic shock.

摘要

Problem: Cardiogenic shock is a dangerous complication of myocardial infarction with a mortality rate around 50%. The majority of clinical data suggests that the most effective treatment to decrease mortality is revascularization. Previous treatment strategies have demonstrated that vasopressor and ionotrope support for perfusion do not effect mortality when used alone. Methods: A Literature Review was performed to identify the treatment and management of cardiogenic shock. Results: Recent research has demonstrated that a systemic inflammatory response due to increased release of nitric oxide may also contribute to the high mortality associated with cardiogenic shock. Mechanical devices have also been utilized in treatment of cardiogenic shock and have proven to be effective in extreme measures as a bridge to transplant. Conclusion: As rates of mortality in cardiogenic shock have remained at 50%, there still remains room for improvement. By understanding the different mechanisms for the treatment of cardiogenic shock, it appears, that the best way to decrease mortality in this patient population relies on the correct balance and combination of these methods.