Abstract:
PURPOSE OF REVIEW:In the past 12 years, atherosclerosis and the acute coronary syndromes have turned out to be thromboinflammatory diseases. Recent data suggest that inflammation also plays an important role in the pathogenesis and outcome of cardiogenic shock. This review will summarize recent advances in the understanding of the pathophysiology of cardiogenic shock related to the inflammatory network and will discuss recent findings in the treatment of patients with cardiogenic shock in relation to these new insights. RECENT FINDINGS:The glycoprotein IIb/IIIa antagonist abciximab has recently been found to be especially useful in the treatment of patients with cardiogenic shock undergoing coronary revascularization with stent implantation, reducing mortality in retrospective analyses from 40 to 50% down to 18 to 26%. Although it remains to be proved whether this is really due to their antiinflammatory effects, other drugs with clear antiinflammatory properties, like the nitric oxide synthase inhibitors L-NAME/L-NMMA, have recently been tested in small series of patients with refractory shock despite coronary revascularization based on the hypothesis that inflammation and impaired vasoreactivity are crucial for the pathogenesis and outcome of cardiogenic shock, with promising results. Other drugs, like a recently developed antibody fragment directed against C5 (pexelizumab) or high-dose statins, await testing in this population with a very high mortality rate. CONCLUSION:The promising results of studies that tested a potential benefit of drugs with clear or potential antiinflammatory/immunomodulatory properties in patients with cardiogenic shock underscores the importance of the inflammatory network in the pathogenesis and outcome of this devastating complication of cardiovascular disease.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Geppert A,Huber Kdoi
10.1097/01.ccx.0000139364.53198.fdkeywords:
subject
Has Abstractpub_date
2004-10-01 00:00:00pages
347-53issue
5eissn
1070-5295issn
1531-7072pii
00075198-200410000-00008journal_volume
10pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:The use of neuromuscular blocking agents (NMBAs) in patients with acute respiratory distress syndrome (ARDS) and acute lung injury remains controversial, although frequent. This review analyzes the effects of NMBAs on thoracopulmonary mechanics, gas exchange, patient outcome and their potential advers...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/mcc.0b013e3283220e60
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abstract:PURPOSE OF REVIEW:To describe the current knowledge about clinical and microbiological diagnosis of nonventilated hospital-acquired pneumonia (NV-HAP). RECENT FINDINGS:NV-HAP is emerging as a new challenge for clinicians, particularly because VAP incidence has been decreasing. The clinical diagnosis of NV-HAP uses the...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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abstract:PURPOSE OF REVIEW:Successful treatment of cardiac arrest requires that an electrically stable and mechanically competent cardiac activity be promptly reestablished. However, many interventions used to attempt to reestablish cardiac activity may also inflict additional myocardial injury and, in turn, compromise resuscit...
journal_title:Current opinion in critical care
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abstract:PURPOSE OF REVIEW:Despite decades of advances in prehospital and in-hospital medical care, patients with out-of-hospital cardiac arrest continue to have poor neurologic and cardiac function following otherwise successful resuscitation. This review examines the mechanisms and therapeutic strategies currently under devel...
journal_title:Current opinion in critical care
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更新日期:2014-06-01 00:00:00
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journal_title:Current opinion in critical care
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更新日期:2005-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Although conventional anticonvulsant agents can terminate status epilepticus in most cases, a substantial minority of patients develops medically refractory status and requires more aggressive care. This review explores the options available. RECENT FINDINGS:Increasing numbers of previously unexpecte...
journal_title:Current opinion in critical care
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更新日期:2005-04-01 00:00:00
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journal_title:Current opinion in critical care
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更新日期:2016-12-01 00:00:00
abstract:PURPOSE OF REVIEW:We discuss the goals of resuscitation, in both the early and the later phases, measures of organ perfusion, fluid responsiveness and the consequences of tissue edema. RECENT FINDINGS:The cost of over-aggressive fluid resuscitation is increased organ failure and mortality. In anticipation of the upcom...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000116
更新日期:2014-08-01 00:00:00
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journal_title:Current opinion in critical care
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更新日期:2014-02-01 00:00:00
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journal_title:Current opinion in critical care
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更新日期:2011-08-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2007-12-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2005-08-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282f1bb32
更新日期:2007-12-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328364d50f
更新日期:2013-10-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000205
更新日期:2015-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Acute kidney injury (AKI) is a frequent finding in critically ill patients and is associated with adverse outcomes. With the purpose of improving outcome of AKI, the Kidney Disease: Improving Global Outcomes (KDIGO) group, a group of experts in critical care nephrology, has presented a set of guidelin...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000039
更新日期:2013-12-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章
doi:10.1097/MCC.0000000000000813
更新日期:2021-01-21 00:00:00
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journal_title:Current opinion in critical care
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更新日期:2013-08-01 00:00:00
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journal_title:Current opinion in critical care
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2018-12-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2014-10-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2010-06-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2004-08-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2020-12-01 00:00:00
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journal_title:Current opinion in critical care
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更新日期:2007-04-01 00:00:00
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journal_title:Current opinion in critical care
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更新日期:2019-04-01 00:00:00
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journal_title:Current opinion in critical care
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journal_title:Current opinion in critical care
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更新日期:2011-10-01 00:00:00
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journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2013-06-01 00:00:00
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journal_title:Current opinion in critical care
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更新日期:2008-02-01 00:00:00