Current concepts on mechanisms and treatment of cardiogenic shock

Luz, Protásio Lemos da; Weil, Max Harry; Shubin, Herbert

doi:10.1016/s0002-8703(76)80409-7

Cited by 18 publications

(6 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the clinical situation, measurement of blood pressure and urine output are obtained routinely to assess whether there is any evidence of significant left ventricular dysfunction [1][2][3]. There are limitations in using these parameters to assess left ventricular systolic function.…”

Section: Discussionmentioning

confidence: 99%

“…Hypotension accompanying acute myocardial infarc tion is frequently associated with a decrease in urine output [1][2][3]. In patients without underlying renal disease, decrease in urine output has been related to decrease in systolic function and urine output therefore has been used as an indirect indicator of left ventricular function [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…In patients without underlying renal disease, decrease in urine output has been related to decrease in systolic function and urine output therefore has been used as an indirect indicator of left ventricular function [1][2][3]. The specific parameters of left ventricular function associated with altered renal function, however, are un clear.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Relationship between Left Ventricular Systolic Function and Plasma Clearance of <sup>169</sup>Yb-DTPA in Normal and Ischemic Dogs

Kaul

Watson

Oliner

et al. 1987

Nephron

View full text Add to dashboard Cite

Plasma clearance of ¹⁶⁹Yb-DTPA, a heavy chelate metal excreted only by glomerular filtration, was measured serially in a canine model to determine whether the clearance of this substance correlates with left ventricular systolic function. Fourteen anesthetized open-chest dogs were studied. Six dogs (group I) were used to estimate the clearance of ¹⁶⁹Yb-DTPA in the setting of normal left ventricular function. Eight dogs (group II) were used to estimate clearance of ¹⁶⁹Yb-DTPA in the presence of ischemic left ventricular dysfunction. Cardiac output, mean arterial pressure, and plasma levels of ¹⁶⁹Yb-DTPA were measured serially. In group II dogs, area at risk for necrosis was defined using myocardial contrast echocardiography. The change in clearance of ¹⁶⁹Yb-DTPA in group II dogs correlated well with change in cardiac output and area at risk (r = 0.80 and -0.93, respectively) and was significantly different from group I dogs (p < 0.01). However, changes in clearance of ¹⁶⁹Yb-DTPA in the group II dogs did not correlate well with change in mean arterial pressure (r = 0.26). In conclusion: (1) clearance of ¹⁶⁹Yb-DTPA is constant over time in the absence of ischemic left ventricular dysfunction and derangement of other hemodynamic parameters; (2) changes in clearance of ¹⁶⁹Yb-DTPA correlate well with changes in systolic pump function and left ventricular area at risk in the setting of ischemic left ventricular dysfunction, and (3) clearance of ¹⁶⁹Yb-DTPA is not related to mean arterial pressure.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between Left Ventricular Systolic Function and Plasma Clearance of <sup>169</sup>Yb-DTPA in Normal and Ischemic Dogs

Kaul

Watson

Oliner

et al. 1987

Nephron

View full text Add to dashboard Cite

show abstract

“…In patients with CGS with acute 1\11, studies have shown in-hospital mortality rates of 65 to 90010 [2,12,13) when revascularization is not attempted. This mortality rate is largely effected by the presence of pre-existing coronary and cardiac disease (elements that limit the development of "compensatory" hyperkinesis) (1).…”

Section: Mechanisms Of Cardiogenic Shockmentioning

confidence: 99%

“…When clinical evidencc of CGS is seen, resuscitative measures should be immediately instituted within an intensive care setting. Stabilization is essential, with establishment ofcentral venous access, airway management, vasoactive/inotropic pressors (especially dobutamine when tolerated) [.181, volume expansion, vasodilators (with extreme caution), and synchronized pacemaker therapy if RV involvement is present [41. Pulmonary arterial catheterization will help establish subsets for hemodynamic management [8][9][10][11][12][13][14][15][16][17][18][19][20]. For example, hypovolemia manifest as decreased filling pressures is present in 20% of patients presenting with CGS [41.…”

Section: Initial Evaluation and Medical Therapy For Cardiogenic Shockmentioning

confidence: 99%

Cardiogenic Shock: Thrombolysis or Angioplasty?

Chou

Amidon

Ports

et al. 1996

J Intensive Care Med

View full text Add to dashboard Cite

Cardiogenic shock (CGS) occurs in 3 to 20% of patients presenting with acute myocardial infarction (MI), and it generally involves dysfunction of at least 40% of the total myocardial mass. Prior to the advent of balloon angioplasty and thrombolysis, in-hospital mortality was greater than 75%. This mortality rate has been consistent in reported series despite the advent of cardiac intensive care units, vasopressor, inotropic, and vasodilator therapy. Intra-aortic balloon counterpulsation therapy provides hemodynamic improvement, and it may provide some mortality benefit when used in conjunction with appropriate revascularization. Survival studies have shown that patency of the infarct-related artery is a strong predictor of survival. No randomized trials have been completed to examine which reperfusion therapy best treats this emergent situation. Subgroup analysis of large scale, multicenter trials, although underpowered, has shown no improvement in mortality with use of thrombolytic agents, leading many to advise use of mechanical intervention. In patients who present with acute MI with contraindications to thrombolysis, primary angioplasty is the treatment of choice. At selected centers, primary angioplasty is comparable to or better than thrombolytic therapy for patients presenting with acute MI, with or without CGS. Studies examining angioplasty in patients with CGS have shown high procedural success rates (75%) and reduced in-hospital mortality (44%), particularly in those patients with successful revascularization. Emergency bypass surgery may improve survival, but it is costly, unavailable to many, and often leads to excessive delays in therapy. If available, we believe that primary angioplasty is the treatment of choice for patients with CGS.

show abstract

Nosologie, Klinik und Therapie des kardiogenen Schocks

Bleifeld¹,

Küpper²

1984

Schock

View full text Add to dashboard Cite

Current concepts on mechanisms and treatment of cardiogenic shock

Cited by 18 publications

References 84 publications

Relationship between Left Ventricular Systolic Function and Plasma Clearance of <sup>169</sup>Yb-DTPA in Normal and Ischemic Dogs

Relationship between Left Ventricular Systolic Function and Plasma Clearance of <sup>169</sup>Yb-DTPA in Normal and Ischemic Dogs

Cardiogenic Shock: Thrombolysis or Angioplasty?

Nosologie, Klinik und Therapie des kardiogenen Schocks

Contact Info

Product

Resources

About