Hemodynamic Monitoring in Cardiogenic Shock

Cardiac failure with a low flow state, clinical and biochemical signs of hypoperfusion albeit increased filling pressures, is defined as cardiogenic shock. These characteristics permit a differential diagnosis from other shock states. Cardiogenic shock is caused by either ventricular or valvular dysfunction, malignant rhythm disturbances, extrinsic factors or several of these. Although the etiologic features of cardiogenic shock are often not easy to determine with routine hemodynamic monitoring tools, routine baseline hemodynamic variables have been shown to be strong predictors of outcome [1][2][3]. Ambulance-transported hypotensive patients with a systolic blood pressure < 100 mmHg had a hospital mortality rate of 25 % [4]. Tailored hemodynamic support is associated with lower mortality in cardiogenic shock patients who are resistant to standard care [5]. In addition, rapid intervention is warranted in ischemic and valvular heart disease and tamponade. In ischemic heart disease, early revascularization is associated with improved late survival compared to initial medical hemodynamic stabilization [6].