Microcirculatory dysfunction in cardiogenic shock

Annals of Intensive Care

Review

Can Ince¹  Christian Jung²  Ferhat Meziani³  Bruno Levy⁴  Martin Siegemund⁵  Hamid Merdji⁵ 

[1] Department of Intensive Care, Erasmus MC, University Medical Center, Rotterdam, The Netherlands;Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, 40225, Düsseldorf, Germany;Faculté de Médecine, Université de Strasbourg (UNISTRA), Strasbourg, France;Service de Médecine Intensive-Réanimation, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, 1, Place de L’Hôpital, 67091, Strasbourg Cedex, France;INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France;Institut Lorrain du Cœur et des Vaisseaux, Medical Intensive Care Unit Brabois, Université de Lorraine, CHRU de Nancy, INSERM U1116, Nancy, France;Intensive Care Unit, Department of Acute Medicine, University Hospital, Basel, Switzerland;Department of Clinical Research, University of Basel, Basel, Switzerland;

关键词: Cardiogenic shock;    Heart failure;    Microcirculation;    Macrocirculation;    Perfusion parameters;   

DOI  :  10.1186/s13613-023-01130-z

 received in 2023-02-15, accepted in 2023-04-13,  发布年份 2023

来源: Springer

【 摘 要 】

Cardiogenic shock is usually defined as primary cardiac dysfunction with low cardiac output leading to critical organ hypoperfusion, and tissue hypoxia, resulting in high mortality rate between 40% and 50% despite recent advances. Many studies have now evidenced that cardiogenic shock not only involves systemic macrocirculation, such as blood pressure, left ventricular ejection fraction, or cardiac output, but also involves significant systemic microcirculatory abnormalities which seem strongly associated with the outcome. Although microcirculation has been widely studied in the context of septic shock showing heterogeneous alterations with clear evidence of macro and microcirculation uncoupling, there is now a growing body of literature focusing on cardiogenic shock states. Even if there is currently no consensus regarding the treatment of microcirculatory disturbances in cardiogenic shock, some treatments seem to show a benefit. Furthermore, a better understanding of the underlying pathophysiology may provide hypotheses for future studies aiming to improve cardiogenic shock prognosis.Graphical Abstract

【 授权许可】

CC BY   
© The Author(s) 2023

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