Choque Cardiogenico.pptx
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The document discusses cardiogenic shock, defined as a critical state of organ hypoperfusion due to primary cardiac dysfunction. It provides details on the pathophysiology, classification, diagnosis, and treatment of cardiogenic shock. Regarding treatment, the document emphasizes early hemodynamic support, inotropic therapy, mechanical circulatory support, and management of precipitating factors as key therapeutic steps in treating patients with cardiogenic shock following acute coronary syndromes.
Choque Cardiogenico.pptx
- 1. Choque Cardiog辿nico R1 Dra Jazm鱈n Alejandra Alarc坦n Gonz叩lez Urgencias M辿dico Quir炭rgicas
- 2. Objetivos Definir shock cardiog辿nico y comprender su fisiopatolog鱈a tras s鱈ndromes coronarios agudos (SCA). Eval炭e al paciente con o en riesgo de shock cardiog辿nico despu辿s de un SCA. Discutir los pasos terap辿uticos y de apoyo clave en el manejo de pacientes con shock cardiog辿nico despu辿s de un SCA.
- 4. Choque cardiog辿nico Estado cr鱈tico de hipoperfusi坦n de 坦rganos diana debido a una disfunci坦n card鱈aca primaria Mebazaa, A., Combes, A., van Diepen, S. et al. Management of cardiogenic shock complicating myocardial infarction. Intensive Care Med 44, 760773 (2018). https://doi.org/10.1007/s00134-018-5214-9
- 5. Alteraci坦n del estado de alerta Criterios diagn坦stico TAS < 90 mmHg en 30min Hipotensi坦n Oliguria Piel y Ext Fr鱈as Aumento Lactato >2mmol/L Mebazaa, A., Combes, A., van Diepen, S. et al. Management of cardiogenic shock complicating myocardial infarction. Intensive Care Med 44, 760773 (2018). https://doi.org/10.1007/s00134-018-5214-9
- 6. Holger Thiele, E Magnus Ohman, Suzanne de Waha-Thiele, Uwe Zeymer, Steffen Desch, Management of cardiogenic shock complicating myocardial infarction: an update 2019, European Heart Journal, Volume 40, Issue 32, 21 August 2019, Pages 26712683, https://doi.org/10.1093/eurheartj/ehz363
- 8. Epidemiolog鱈a SICA 65119 AOS 1999-2007 SC 4.6% (6-9%) T. MORT 59.4% 1679 UIC SOAP II Shock S辿ptico Shock Cardiog辿nico Shock Hipovol辿mico 62% 17% 16% Cecconi, M., De Backer, D., Antonelli, M. et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med 40, 17951815 (2014). https://doi.org/10.1007/s00134-014-3525-z
- 9. Etiolog鱈a 03
- 11. Shilpa Narayan, Md, Tara L. Petersen, Md, Ms, Uncommon Etiologies Of Shock, Review Article| Volume 38, Issue 2, P429-441, April 2022, Doi:https://Doi.Org/10.1016/J.Ccc.2021.11.009
- 13. Fisiopatolog鱈a Eder I. Zamarr坦n L坦pez MD, Alvaro E. Ram鱈rez Guti辿rrez MD , Orlando R. P辿rez Nieto MD , Paola Villa Cort辿s MD , Manuel A. Guerrero Guiti辿rrez MD,*, Silvia UribeMoya MD. Abordaje contempor叩neo del choque cardiog辿nico, Revista Chilena de Anestesia Vol. 50 N炭m. 6 pp. 799-805, https://doi.org/10.25237/revchilanestv5001101033.
- 14. Harjola VP, Mullens W, Banaszewski M, Bauersachs J, Brunner-La Rocca HP, Et al. Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur J Heart Fail. 2017 Jul;19(7):821-836. doi: 10.1002/ejhf.872. Epub 2017 May 30. PMID: 28560717; PMCID: PMC5734941.
- 15. Chioncel O, Parissis J, Mebazaa A, Thiele H, Desch S, Bauersachs J, Harjola VP, Antohi EL, Et al. Epidemiology, pathophysiology and contemporary management of cardiogenic shock - a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2020 Aug;22(8):1315-1341. doi: 10.1002/ejhf.1922.Epub 2020 Jul 16. Erratum in: Eur J Heart Fail. 2021 Feb;23(2):345. PMID: 32469155.
- 16. Clasificaci坦n 05
- 17. Chioncel O, Parissis J, Mebazaa A, Thiele H, Desch S, Bauersachs J, Harjola VP, Antohi EL, Et al. Epidemiology, pathophysiology and contemporary management of cardiogenic shock - a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2020 Aug;22(8):1315-1341. doi: 10.1002/ejhf.1922.Epub 2020 Jul 16. Erratum in: Eur J Heart Fail. 2021 Feb;23(2):345. PMID: 32469155.
- 18. Katherine L. Hill, Aprn, Cns, Dnp, Mark A. Rustin, Rn, Ccrn, Michele A. Asche, Aprn, Cns, Ms, Courtney E. Bennett, Do, Parag C. Patel, Md, Jacob C. Jentzer, Md, Cardiogenic Shock Classification And Associated Mortality Risk, Review| Volume 98, Issue 5, P771-783, May 2023, Published: April 05, 2023, https://doi.org/10.1016/j.mayocp.2022.12.007
- 19. Tratamiento 06
- 21. Katherine L. Hill, Aprn, Cns, Dnp, Mark A. Rustin, Rn, Ccrn, Michele A. Asche, Aprn, Cns, Ms, Courtney E. Bennett, Do, Parag C. Patel, Md, Jacob C. Jentzer, Md, Cardiogenic Shock Classification And Associated Mortality Risk, Review| Volume 98, Issue 5, P771-783, May 2023, Published: April 05, 2023, https://doi.org/10.1016/j.mayocp.2022.12.007
- 22. Katherine L. Hill, Aprn, Cns, Dnp, Mark A. Rustin, Rn, Ccrn, Michele A. Asche, Aprn, Cns, Ms, Courtney E. Bennett, Do, Parag C. Patel, Md, Jacob C. Jentzer, Md, Cardiogenic Shock Classification And Associated Mortality Risk, Review| Volume 98, Issue 5, P771-783, May 2023, Published: April 05, 2023, https://doi.org/10.1016/j.mayocp.2022.12.007
- 23. Jacqueline T DesJardin, John R Teerlink, Inotropic therapies in heart failure and cardiogenic shock: an educational review, European Heart Journal. Acute Cardiovascular Care, Volume 10, Issue 6, August 2021, Pages 676686, https://doi.org/10.1093/ehjacc/zuab047
- 24. Jacqueline T DesJardin, John R Teerlink, Inotropic therapies in heart failure and cardiogenic shock: an educational review, European Heart Journal. Acute Cardiovascular Care, Volume 10, Issue 6, August 2021, Pages 676686, https://doi.org/10.1093/ehjacc/zuab047
- 25. Holger Thiele, E Magnus Ohman, Suzanne de Waha-Thiele, Uwe Zeymer, Steffen Desch, Management of cardiogenic shock complicating myocardial infarction: an update 2019, European Heart Journal, Volume 40, Issue 32, 21 August 2019, Pages 26712683, https://doi.org/10.1093/eurheartj/ehz363
- 26. Holger Thiele, E Magnus Ohman, Suzanne de Waha-Thiele, Uwe Zeymer, Steffen Desch, Management of cardiogenic shock complicating myocardial infarction: an update 2019, European Heart Journal, Volume 40, Issue 32, 21 August 2019, Pages 26712683, https://doi.org/10.1093/eurheartj/ehz363
- 27. Mebazaa, A., Combes, A., van Diepen, S. et al. Management of cardiogenic shock complicating myocardial infarction. Intensive Care Med 44, 760773 (2018). https://doi.org/10.1007/s00134-018-5214-9 Garnica Camacho, C辿sar Enrique, Rivero Sigarroa, Eduardo, & Dom鱈nguez Cherit, Guillermo. (2019). Choque cardiog辿nico: de la definici坦n al abordaje. Medicina cr鱈tica (Colegio Mexicano de Medicina Cr鱈tica), 33(5), 251-258. Epub 30 de julio de 2021. Recuperado en 05 de mayo de 2023, de http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448- 89092019000500251&lng=es&tlng=es Holger Thiele, E Magnus Ohman, Suzanne de Waha-Thiele, Uwe Zeymer, Steffen Desch, Management of cardiogenic shock complicating myocardial infarction: an update 2019, European Heart Journal, Volume 40, Issue 32, 21 August 2019, Pages 26712683, https://doi.org/10.1093/eurheartj/ehz363 Eder I. Zamarr坦n L坦pez MD, Alvaro E. Ram鱈rez Guti辿rrez MD , Orlando R. P辿rez Nieto MD , Paola Villa Cort辿s MD , Manuel A. Guerrero Guiti辿rrez MD,*, Silvia UribeMoya MD. Abordaje contempor叩neo del choque cardiog辿nico, Revista Chilena de Anestesia Vol. 50 N炭m. 6 pp. 799-805, https://doi.org/10.25237/revchilanestv5001101033 Shilpa Narayan, Md, Tara L. Petersen, Md, Ms, Uncommon Etiologies Of Shock, Review Article| Volume 38, Issue 2, P429-441, April 2022, https://Doi.Org/10.1016/J.Ccc.2021.11.009 Cyrus Vahdatpour MD, David Collins MD , and Sheldon Goldberg MD, FACC, Cardiogenic Shock, Apr 2019, Journal of the American Heart Association. 2019;8:e011991, https://doi.org/10.1161/JAHA.119.011991 Cecconi, M., De Backer, D., Antonelli, M. et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med 40, 17951815 (2014). https://doi.org/10.1007/s00134-014-3525-z Chioncel O, Parissis J, Mebazaa A, Thiele H, Desch S, Bauersachs J, Harjola VP, Antohi EL, Et al. Epidemiology, pathophysiology and contemporary management of cardiogenic shock - a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2020 Aug;22(8):1315-1341. doi: 10.1002/ejhf.1922.Epub 2020 Jul 16. Erratum in: Eur J Heart Fail. 2021 Feb;23(2):345. PMID: 32469155. Harjola VP, Mullens W, Banaszewski M, Bauersachs J, Brunner-La Rocca HP, Et al. Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur J Heart Fail. 2017 Jul;19(7):821- 836. doi: 10.1002/ejhf.872. Epub 2017 May 30. PMID: 28560717; PMCID: PMC5734941. Katherine L. Hill, Aprn, Cns, Dnp, Mark A. Rustin, Rn, Ccrn, Michele A. Asche, Aprn, Cns, Ms, Courtney E. Bennett, Do, Parag C. Patel, Md, Jacob C. Jentzer, Md, Cardiogenic Shock Classification And Associated Mortality Risk, Review| Volume 98, Issue 5, P771-783, May 2023, Published: April 05, 2023, https://doi.org/10.1016/j.mayocp.2022.12.007 Jacqueline T DesJardin, John R Teerlink, Inotropic therapies in heart failure and cardiogenic shock: an educational review, European Heart Journal. Acute Cardiovascular Care, Volume 10, Issue 6, August 2021, Pages 676686, https://doi.org/10.1093/ehjacc/zuab047 Bibliografia
- 28. THANKS!
Editor's Notes
- #23: Management of patients with or at risk for cardiogenic shock guided by the Society for Cardiovascular Angiography and Interventions (SCAI) Shock Classification. For patients in each SCAI shock stage, specific evaluation and management options may be considered to tailor the intensity of care to the severity of cardiogenic shock. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device; MCS, mechanical circulatory support; MI, myocardial infarction; +/,with or without.
- #24: Example of an automated Society for Cardiovascular Angiography and Interventions (SCAI) Shock Classification algorithm embedded in the electronic health record (EHR) to alert clinicians about cardiogenic shock (CS) development. ICU, intensive care unit; labs, laboratory studies; MCS, mechanical circulatory support; PAC, pulmonary artery catheter; RRT, rapid response team.