Value of Hemodynamic Monitoring in Patients With Cardiogenic Shock Undergoing Mechanical Circulatory Support
Value of Hemodynamic Monitoring in Patients With Cardiogenic Shock Undergoing Mechanical Circulatory Support
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DOI：
10.1161/circulationaha.119.043080
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发表时间：
2020-04-07
期刊：
影响因子：
37.8
通讯作者：
Kern, Morton
中科院分区：
文献类型：
--
作者：
Saxena, Abhinav;Garan, A. Reshad;Kern, Morton
机械循环支持的广泛应用正在改变心源性休克（CS）的治疗和结局。通过肺动脉导管（PAC）的血流动力学监测，可以有效指导CS患者优化治疗的临床决策。由于几项关于PAC获益的研究不明确，因此治疗CS患者的临床医生对PAC的使用各不相同。更值得注意的是，PAC的使用尚未作为CS患者（有或无机械循环支持）的随机对照试验的一部分进行研究。标准化的血流动力学监测方法可以改善这些患者的决策和结局。在这篇综述中，我们总结了CS和机械循环支持的血流动力学与PAC衍生的测量，并提供了一个令人信服的理由，在CS患者接受机械循环支持的PAC监测。
The recent widespread availability and use of mechanical circulatory support is transforming the management and outcomes of cardiogenic shock (CS). Clinical decision-making regarding the optimization of therapies for patients with CS can be guided effectively by hemodynamic monitoring with a pulmonary artery catheter (PAC). Because several studies regarding the benefit of PACs are ambiguous, the use of PACs is variable among clinicians treating patients with CS. More notable is that PAC use has not been studied as part of a randomized, controlled trial in patients with CS with or without mechanical circulatory support. Standardized approaches to hemodynamic monitoring in these patients can improve decision-making and outcomes. In this review, we summarize the hemodynamics of CS and mechanical circulatory support with PAC-derived measurements, and provide a compelling rationale for the use of PAC monitoring in patients with CS receiving mechanical circulatory support.