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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...

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Autores principales: Jung, Christian, Lauten, Alexander, Ferrari, Markus
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
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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.
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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
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