Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Microcirculation in cardiogenic shock: from scientific bystander to therapy target. | Jung et al. Critical Care 2010 14 193 http content 14 5 193 CRITICAL CARE COMMENTARY L__ Microcirculation in cardiogenic shock from scientific bystander to therapy target Christian Jung Alexander Lauten and Markus Ferrari See related research by Munsterman etal. http content 14 4 R161 Abstract 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. Despite diagnostic and therapeutic improvements cardiogenic shock CS is still the most common cause of death in patients with acute myocardial infarction. Although percutaneous coronary intervention PCI inotropes fluids adjunctive medication intra-aortic balloon pump IABP and ventricular assist devices are widely available mortality rates in patients with CS remain high 40 to 50 . Therefore Munsterman and Correspondence First Department of Internal Medicine Cardiology Angiology Pneumology Intensive Care Medicine Friedrich-Schiller University .
