Sốc tim mạch do nhồi máu

Herz - Tập 47 Số 1 - Trang 85-100 - 2022
Werdan, Karl1,2, Ferrari, Markus Wolfgang3, Prondzinsky, Roland4, Ruß, Martin5
1Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
2Halle (Saale), Deutschland
3Klinik für Innere Medizin I, Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Deutschland
4Klinik für Innere Medizin I, Carl-von-Basedow-Klinikum Saalekreis gGmbH, Bereich Merseburg, Merseburg, Deutschland
5Internisten am Marktplatz, Traunstein/Belegkardiologie Traunstein, Traunstein, Deutschland

Tóm tắt

Sốc tim mạch như một biến chứng của nhồi máu (5–10%) tăng cường tỷ lệ tử vong của nhồi máu cơ tim không biến chứng từ dưới 10% lên khoảng 40%, do sự phát triển của hội chứng rối loạn chức năng đa cơ quan do sự suy giảm nghiêm trọng tưới máu cơ quan do sốc. Do đó, liệu pháp theo hướng dẫn không nên chỉ giới hạn ở việc tái thông mạch vành bị tắc và điều trị các biến chứng của nhồi máu. Việc tối ưu hóa lưu lượng máu cơ quan theo thể tích tim cũng rất quan trọng cho sự sống còn, thông qua các chất inotropic và vasoactive, cũng như – trong trường hợp có chỉ định nghiêm ngặt – với các hệ thống hỗ trợ cơ học tạm thời, nhưng không phải với bơm bóng trong động mạch chủ. Các biện pháp chăm sóc tích cực đặc thù cho sốc cũng rất quan trọng, chẳng hạn như thở bảo vệ phổi trong trường hợp phải thở máy.

Từ khóa

#sốc tim mạch #nhồi máu cơ tim #hội chứng rối loạn chức năng đa cơ quan #liệu pháp điều trị #tối ưu hóa lưu lượng máu #hỗ trợ cơ học tạm thời #thở bảo vệ phổi

Tài liệu tham khảo

citation_journal_title=Eur Heart J; citation_title=Impact of treatment delay on mortality in ST-segment elevation myocardial infarction (STEMI) patients presenting with and without haemodynamic instability: results from the German prospective, multicentre FITT-STEMI trial; citation_author=KH Scholz, SKG Maier, LS Maier; citation_volume=39; citation_publication_date=2018; citation_pages=1065-1074; citation_id=CR1 citation_journal_title=Eur Heart J Acute Cardiovasc Care; citation_title=Acute Cardiovascular Care Association position statement for the diagnosis and treatment of patients with acute myocardial infarction complicated by cardiogenic shock: A document of the Acute Cardiovascular Care Association of the European Society of Cardiology; citation_author=U Zeymer, H Bueno, CB Granger; citation_volume=9; citation_publication_date=2020; citation_pages=183-197; citation_id=CR2 AWMF-Leitlinien-Register Nr. 019/013 (2019) Deutsch-österreichische S3 Leitlinie „Infarktbedingter kardiogener Schock – Diagnose, Monitoring und Therapie“. Federführung: Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V.; unter Mitwirkung weiterer Fachgesellschaften. 019-013l_S3_Infarktbedingter_kardiogener_Schock_2019-11.pdf. Zugegriffen: 3. Dez .2021 citation_title=Pocket-Leitlinie Deutsch-österreichische S3-Leitlinie Infarkt-bedingter kardiogener Schock – Diagnose, Monitoring und Therapie Update 2020 (dgk.org); citation_publication_date=2020; citation_id=CR4 citation_journal_title=Intensiv- und Notfallbehandlung; citation_title=Deutsch-österreichische S3 Leitlinie Infarktbedingter kardiogener Schock – Diagnose, Monitoring und Therapie; citation_author=K Werdan, U Boeken, J Briegel; citation_volume=46; citation_publication_date=2021; citation_pages=1-110; citation_id=CR5 citation_journal_title=Kardiologe; citation_title=Kurzversion der 2. Auflage der deutsch-österreichischen S3-Leitlinie „Infarkt-bedingter Kardiogener Schock – Diagnose, Monitoring und Therapie“; citation_author=K Werdan, U Boeken, MJ Briegel; citation_volume=14; citation_publication_date=2020; citation_pages=364-395; citation_id=CR6 citation_journal_title=Dtsch Arztebl Int; citation_title=Clinical practice guideline: Infarction-related cardiogenic shock—diagnosis, monitoring and therapy. A German-Austrian S3 guideline; citation_author=K Werdan, M Buerke, A Geppert, H Thiele, M Ruß; citation_volume=118; citation_publication_date=2021; citation_pages=88-95; citation_id=CR7 citation_journal_title=Thorac Cardiovasc Surg; citation_title=The German-Austrian S3 guideline “Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment”. Thorac Cardiovasc Surg; citation_author=K Pilarczyk, K Werdan, M Russ; citation_publication_date=2020; citation_doi=10.1055/s-0040-1719155; citation_id=CR8 citation_journal_title=N Engl J Med; citation_title=Intraaortic balloon support for myocardial infarction with cardiogenic shock; citation_author=H Thiele, U Zeymer, F-J Neumann; citation_volume=367; citation_publication_date=2012; citation_pages=1287-1296; citation_id=CR9 citation_journal_title=Am Heart J; citation_title=Impact of access site choice on outcomes of patients with cardiogenic shock undergoing percutaneous coronary intervention: a systematic review and meta-analysis; citation_author=SB Pancholy, G Palamaner Subash Shantha; citation_volume=170; citation_publication_date=2015; citation_pages=353-361; citation_id=CR10 citation_journal_title=N Engl J Med; citation_title=PCI strategies in patients with acute myocardial infarction and cardiogenic shock; citation_author=H Thiele, I Akin, M Sandri; citation_volume=377; citation_publication_date=2017; citation_pages=2419-2432; citation_id=CR11 citation_journal_title=Lancet; citation_title=Intraaortic balloon counterpulsation in acute myocadial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12-month results of a randomized, open-label trial; citation_author=H Thiele, U Zeymer, F-J Neumann; citation_volume=382; citation_publication_date=2013; citation_pages=1638-1645; citation_id=CR12 citation_journal_title=Intensive Care Med; citation_title=The diagnostic accuracy of clinical examination for estimating cardiac index in critically ill patients: the Simple Intensive Care Studies-I; citation_author=B Hiemstra, G Koster, R Wiersema; citation_volume=45; citation_publication_date=2019; citation_pages=190-200; citation_id=CR13 citation_journal_title=Kardiologe; citation_title=Empfehlungen zum hämodynamischen Monitoring in der internistischen Intensivmedizin; citation_author=U Janssens, C Jung, M Hennersdorf; citation_volume=10; citation_publication_date=2016; citation_pages=149-169; citation_id=CR14 citation_journal_title=Intensiv Notfallbehandl; citation_title=Pharmakotherapie bei akuter Herzinsuffizienz und im kardiogenen Schock; citation_author=K Ferrari-Kühne, MW Ferrari; citation_volume=46; citation_issue=3; citation_publication_date=2021; citation_pages=94-100; citation_id=CR15 citation_journal_title=J Am Coll Cardiol; citation_title=Epinephrine versus norepinephrine for cardiogenic shock after acute myocardial infarction; citation_author=B Levy, R Clere-Jehl, A Legras; citation_volume=72; citation_publication_date=2018; citation_pages=173-182; citation_id=CR16 citation_journal_title=Crit Care Med; citation_title=Levosimendan is superior to enoximone in refractory cardiogenic shock complicating acute myocardial infarction; citation_author=JT Fuhrmann, A Schmeisser, MR Schulze; citation_volume=36; citation_publication_date=2008; citation_pages=2257-2266; citation_id=CR17 citation_journal_title=Crit Care Med; citation_title=Intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: the prospective, randomized IABP SHOCK trial for attenuation of multiorgan dysfunctions syndrome; citation_author=R Prondzinsky, H Lemm, M Swyter; citation_volume=3; citation_publication_date=2010; citation_pages=152-160; citation_id=CR18 citation_journal_title=Eur Heart J; citation_title=Mechanical circulatory support in cardiogenic shock; citation_author=K Werdan, S Gielen, H Ebelt, JS Hochman; citation_volume=35; citation_publication_date=2014; citation_pages=156-167; citation_id=CR19 citation_journal_title=Med Klin Intensivmed Notfmed; citation_title=Mechanische Kreislaufunterstützung beim kardiogenen Schock (CME Zertifizierte Fortbildung); citation_author=MW Ferrari; citation_volume=114; citation_publication_date=2019; citation_pages=77-90; citation_id=CR20 citation_title=S3 Leitlinie „Einsatz der extrakorporalen Zirkulation (ECLS/ECMO) bei Herz- und Kreislaufversagen“. Federführung: Deutsche Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie e. V.; unter Mitwirkung weiterer Fachgesellschaften; citation_publication_date=2020; citation_id=CR21 citation_journal_title=Thorax Cardiovasc Surg; citation_title=Extracorporeal circulation (ECLS/ECMO) for cardiocirculatory failure—Summary of the S3 guideline; citation_author=U Boeken, A Assmann, A Beckmann; citation_volume=69; citation_publication_date=2021; citation_pages=483-489; citation_id=CR22 citation_journal_title=Clin Res Cardiol; citation_title=Cardiogenic shock: incidence, survival and mechanical circulatory support usage 2007–2017—Insights from a national registry; citation_author=CN Lang, K Kaier, V Zotzmann; citation_volume=110; citation_publication_date=2021; citation_pages=1421-1430; citation_id=CR23 citation_journal_title=Eur Heart J; citation_title=Percutaneous short-term active mechanical support devices in cardiogenic shock: a systematic review and collaborative meta-analysis of randomized trials; citation_author=H Thiele, A Jobs, DM Ouweneel; citation_volume=38; citation_publication_date=2017; citation_pages=3523-3531; citation_id=CR24 citation_journal_title=Intensive Care Med; citation_title=Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis; citation_author=DM Ouweneel, JV Schotborgh, J Limpens; citation_volume=42; citation_publication_date=2016; citation_pages=1922-1934; citation_id=CR25 citation_journal_title=Crit Care Med; citation_title=The multiple organ dysfunction syndrome: syndrome, metaphor, and unsolved clinical challenge; citation_author=JC Marshall, JC Deutschman; citation_volume=49; citation_issue=9; citation_publication_date=2021; citation_pages=1402-1413; citation_id=CR26 citation_journal_title=Clin Res Cardiol; citation_title=A prospective, randomized trial of continuous lateral rotation (“kinetic therapy”) in patients with cardiogenic shock; citation_author=G Simonis, K Steiding, K Schaefer; citation_volume=101; citation_publication_date=2012; citation_pages=955-962; citation_id=CR27 citation_journal_title=Med Klin Intensivmed Notfmed; citation_title=Lung protective ventilation and hospital survival of cardiac intensive care patients; citation_author=M Schneck, K Holder, S Gielen; citation_volume=111; citation_issue=6; citation_publication_date=2016; citation_pages=508-513; citation_id=CR28 citation_journal_title=Crit Care; citation_title=Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis; citation_author=L Guo, W Wang, N Zhao; citation_volume=20; citation_publication_date=2016; citation_pages=226; citation_id=CR29 citation_journal_title=Med Klin Intensivmed Notfmed; citation_title=Spezielle Aspekte der Analgosedierung bei Patienten mit kardiogenem Schock; citation_author=H Lemm, M Janusch, M Buerke; citation_volume=111; citation_publication_date=2016; citation_pages=22-26; citation_id=CR30 citation_journal_title=Curr Opin Crit Care; citation_title=Weaning the cardiac patient from mechanical ventilation; citation_author=M Dres, JL Teboul, X Monnet; citation_volume=20; citation_publication_date=2014; citation_pages=493-498; citation_id=CR31 citation_journal_title=Crit Care; citation_title=Acute kidney injury treated with renal replacement therapy and 5-year mortality after myocardial infarction-related cardiogenic shock: a nationwide population-based cohort study; citation_author=MD Lauridsen, H Gammelager, M Schmidt; citation_volume=19; citation_publication_date=2015; citation_pages=452; citation_id=CR32 citation_journal_title=Nephro-News; citation_title=Akute Nierenschädigung: Hilft frühe Nierenersatztherapie?; citation_author=V Schwenger; citation_volume=22; citation_publication_date=2020; citation_pages=24-27; citation_id=CR33 citation_journal_title=Kardiologe; citation_title=Hepatische Dysfunktion bei Patienten mit kardiogenem Schock (CME Zertifizierte Fortbildung); citation_author=P Kasper, F Tacke, H Steffen, G Michels; citation_volume=14; citation_publication_date=2020; citation_pages=229-238; citation_id=CR34 citation_journal_title=Intensive Care Med; citation_title=Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on abdominal problems; citation_author=A Reintam Blaser, ML Malbrain, J Starkopf; citation_volume=38; citation_publication_date=2012; citation_pages=384-394; citation_id=CR35 citation_journal_title=Aktuel Ernahrungsmed; citation_title=DGEM-Leitlinie: „Klinische Ernährung in der Intensivmedizin“; citation_author=G Elke, WH Hartl, KG Kreymann; citation_volume=43; citation_publication_date=2018; citation_pages=341-408; citation_id=CR36 citation_journal_title=Clin Res Cardiol; citation_title=Prognostic impact of baseline glucose levels in acute myocardial infarction complicated by cardiogenic shock—A substudy of the IABP-SHOCK II-trial; citation_author=A Abdin, J Pöss, G Fuernau; citation_volume=107; citation_publication_date=2018; citation_pages=517-523; citation_id=CR37 citation_journal_title=Clin Res Cardiol; citation_title=Association between anemia and hematological indices with mortality among cardiac intensive care unit patients; citation_author=H Rayes, S Vallabhajosyula, GW Barsness; citation_volume=109; citation_publication_date=2020; citation_pages=616-627; citation_id=CR38 citation_journal_title=JAMA; citation_title=Effect of a restrictive vs liberal blood transfusion strategy on major cardiovascular events among patients with acute myocardial infarction and anemia; citation_author=G Ducrocq, JR Gonzalez-Juanatey, E Puymirat; citation_volume=325; citation_publication_date=2021; citation_pages=552-560; citation_id=CR39 citation_title=Querschnitts-Leitlinien zur Therapie mit Blutkomponenten und Plasmaderivaten Gesamtnovelle 2020; citation_publication_date=2020; citation_id=CR40 citation_journal_title=JAMA; citation_title=Effect of stress ulcer prophylaxis with proton pump inhibitors vs histamine-2-receptor blockers on in-hospital mortality among ICU patients receiving invasive mechanical ventilation The PEPTIC randomized clinical trial; citation_author=PJ Young, SM Bagshaw, AB Forbes; citation_volume=323; citation_publication_date=2020; citation_pages=616-626; citation_id=CR41 citation_journal_title=Intensiv Notfallbehandl; citation_title=Gastrointestinale Blutung auf Intensivstation – wer bekommt den „Magenschutz“?; citation_author=T Puengel, F Tacke; citation_volume=46; citation_issue=3; citation_publication_date=2021; citation_pages=101-107; citation_id=CR42 citation_journal_title=J Card Fail; citation_title=Right ventricular dysfunction in acute myocardial infarction complicated by cardiogenic shock: a hemodynamic analysis of the should be emergently revascularize occluded coronaries for cardiogenic shock (SHOCK) trial and registry; citation_author=A Lala, Y Guo, J Xu; citation_volume=24; citation_publication_date=2018; citation_pages=148-156; citation_id=CR43 citation_journal_title=Eur J Heart Fail; citation_title=Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology; citation_author=VP Harjola, A Mebazaa, J Celutkiené; citation_volume=18; citation_publication_date=2016; citation_pages=226-241; citation_id=CR44 citation_journal_title=Minerva Cardioangiol; citation_title=Cardiogenic shock: management of right ventricular infarction shock; citation_author=M Ruiz-Bailén, MI Ruiz Garcia, A Ferrezuelo Mata; citation_volume=60; citation_publication_date=2012; citation_pages=167-174; citation_id=CR45 citation_journal_title=Ann Noninvasive Electrocardiol; citation_title=The prognostic significance of early and late right precordial lead (V4R) ST-segment elevation in patients with acute anterior myocardial infarction; citation_author=M Keskin, AO Uzun, EB Börklü; citation_volume=23; citation_publication_date=2018; citation_pages=e12513; citation_id=CR46 citation_journal_title=World J Cardiol; citation_title=Primary reperfusion in acute right ventricular infarction: an observational study; citation_author=E Lupi-Herrera, H Gonzaléz-Pacheco, U Juárez-Herrera; citation_volume=6; citation_publication_date=2014; citation_pages=14-22; citation_id=CR47 citation_journal_title=Crit Care Med; citation_title=Right ventricular function in myocardial infarction complicated by cardiogenic shock: improvement with levosimendan; citation_author=MA Russ, R Prondzinsky, JM Carter; citation_volume=37; citation_publication_date=2009; citation_pages=3017-3023; citation_id=CR48 citation_journal_title=Notfall Rettungsmed; citation_title=ERC-Reanimationsleitlinien Alle Kapitel inkl. Übersetzung des GRC; citation_author=; citation_volume=24; citation_publication_date=2021; citation_pages=271-772; citation_id=CR49 citation_journal_title=Med Klin Intensivmed Notfmed; citation_title=Empfehlungen zur extrakorporalen kardiopulmonalen Reanimation (eCPR): Konsensuspapier der DGIIN, DGK, DGTHG, DGfK, DGNI, DGAI, DIVI und GRC; citation_author=G Michels, T Wengenmayer, C Hagl; citation_volume=113; citation_publication_date=2018; citation_pages=478-486; citation_id=CR50 citation_journal_title=JAMA; citation_title=Serum potassium levels and mortality in acute myocardial infarction; citation_author=A Goyal, JA Spertus, K Gosch; citation_volume=307; citation_publication_date=2012; citation_pages=157-164; citation_id=CR51 citation_journal_title=JAMA Cardiol; citation_title=Mechanical complications in acute myocardial infarction a review; citation_author=FF Gong, I Valtenas, C Malaisrie; citation_volume=6; citation_publication_date=2020; citation_pages=341-349; citation_id=CR52 citation_journal_title=Circulation; citation_title=Intraaortic balloon pump in cardiogenic shock complicating myocardial infarction long-term 6‑year outcome of the randomized IABP-SHOCK II trial; citation_author=H Thiele, U Zeymer, N Thelemann; citation_volume=139; citation_issue=3; citation_publication_date=2019; citation_pages=395-403; citation_id=CR53