Abstract:
PURPOSE OF REVIEW:The natural history of cardiogenic shock has improved significantly with the utilization of revascularization and mechanical circulatory support. Despite the interest in identifying new pharmacological agents, the medical therapy to restore perfusion is limited by their side-effects and no solid evidence about improving outcomes. In this article, we review the current pharmacological agents utilized during cardiogenic shock. RECENT FINDINGS:Inotropes and vasopressors are widely used to improve hemodynamics acutely; however, reliable information regarding comparative efficacy of individual agents is lacking. A subanalysis of a prospective randomized trial suggested that norepinephrine may be preferred over dopamine in patients with cardiogenic shock. Levosimendan is a new inotrope with calcium sensitization properties that improves acute hemodynamics, but with uncertain effects in mortality. Diuretics are used to decongest patients; however, mortality data are not available. Inhibition of inflammation during cardiogenic shock seems to be a potential therapeutic target; however, initial clinical studies in this area have not shown benefit. SUMMARY:The current pharmacological treatment for cardiogenic shock includes inotropes, vasopressors and diuretics. The information about comparative effective outcomes is limited and their use should be limited as a temporary measure as a bridge to recovery, mechanical circulatory support or heart transplantation.
journal_name
Curr Opin Cardioljournal_title
Current opinion in cardiologyauthors
Nativi-Nicolau J,Selzman CH,Fang JC,Stehlik Jdoi
10.1097/HCO.0000000000000057subject
Has Abstractpub_date
2014-05-01 00:00:00pages
250-7issue
3eissn
0268-4705issn
1531-7080journal_volume
29pub_type
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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journal_title:Current opinion in cardiology
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