Cargando…
Microcirculation in cardiogenic shock: from scientific bystander to therapy target
Despite diagnostic and therapeutic improvements, mortality rates in patients with cardiogenic shock remain relatively high. Several studies showed that cardiogenic shock is associated with alterations in the microvascular circulation. These alterations may be reversed by extracorporeal support devic...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2010
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219249/ https://www.ncbi.nlm.nih.gov/pubmed/20828425 http://dx.doi.org/10.1186/cc9244 |
_version_ | 1782216802496937984 |
---|---|
author | Jung, Christian Lauten, Alexander Ferrari, Markus |
author_facet | Jung, Christian Lauten, Alexander Ferrari, Markus |
author_sort | Jung, Christian |
collection | PubMed |
description | Despite diagnostic and therapeutic improvements, mortality rates in patients with cardiogenic shock remain relatively high. Several studies showed that cardiogenic shock is associated with alterations in the microvascular circulation. These alterations may be reversed by extracorporeal support devices. A study by Munsterman and colleagues adds to the body of evidence showing that in patients deemed ready for discontinuing intra-aortic balloon pump (IABP) support, microcirculatory flow in small vessels increases after ceasing IABP therapy. This study not only highlights the need for optimal timing of weaning from IABP support but also supports recent findings that global hemodynamics do not necessarily result in changes of microvascular perfusion. All modalities of modern treatment in cardiogenic shock need to be evaluated for their effect on the microcirculation. Microcirculatory evaluations should be part of randomized controlled trial protocols. More effort is needed to improve outcomes and understand the microcirculation as a therapy target and not as a silent bystander. |
format | Online Article Text |
id | pubmed-3219249 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32192492011-11-18 Microcirculation in cardiogenic shock: from scientific bystander to therapy target Jung, Christian Lauten, Alexander Ferrari, Markus Crit Care Commentary Despite diagnostic and therapeutic improvements, mortality rates in patients with cardiogenic shock remain relatively high. Several studies showed that cardiogenic shock is associated with alterations in the microvascular circulation. These alterations may be reversed by extracorporeal support devices. A study by Munsterman and colleagues adds to the body of evidence showing that in patients deemed ready for discontinuing intra-aortic balloon pump (IABP) support, microcirculatory flow in small vessels increases after ceasing IABP therapy. This study not only highlights the need for optimal timing of weaning from IABP support but also supports recent findings that global hemodynamics do not necessarily result in changes of microvascular perfusion. All modalities of modern treatment in cardiogenic shock need to be evaluated for their effect on the microcirculation. Microcirculatory evaluations should be part of randomized controlled trial protocols. More effort is needed to improve outcomes and understand the microcirculation as a therapy target and not as a silent bystander. BioMed Central 2010 2010-09-06 /pmc/articles/PMC3219249/ /pubmed/20828425 http://dx.doi.org/10.1186/cc9244 Text en Copyright ©2010 BioMed Central Ltd |
spellingShingle | Commentary Jung, Christian Lauten, Alexander Ferrari, Markus Microcirculation in cardiogenic shock: from scientific bystander to therapy target |
title | Microcirculation in cardiogenic shock: from scientific bystander to therapy target |
title_full | Microcirculation in cardiogenic shock: from scientific bystander to therapy target |
title_fullStr | Microcirculation in cardiogenic shock: from scientific bystander to therapy target |
title_full_unstemmed | Microcirculation in cardiogenic shock: from scientific bystander to therapy target |
title_short | Microcirculation in cardiogenic shock: from scientific bystander to therapy target |
title_sort | microcirculation in cardiogenic shock: from scientific bystander to therapy target |
topic | Commentary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219249/ https://www.ncbi.nlm.nih.gov/pubmed/20828425 http://dx.doi.org/10.1186/cc9244 |
work_keys_str_mv | AT jungchristian microcirculationincardiogenicshockfromscientificbystandertotherapytarget AT lautenalexander microcirculationincardiogenicshockfromscientificbystandertotherapytarget AT ferrarimarkus microcirculationincardiogenicshockfromscientificbystandertotherapytarget |