Evidence mapPaperPMID 33827749Full record

GuidelineDeutsches Arzteblatt international2021

Infarction-Related Cardiogenic Shock- Diagnosis, Monitoring and Therapy–A German-Austrian S3 Guideline.

Karl Werdan, Michael Buerke, Alexander Geppert, Holger Thiele, Bernd Zwissler, Martin Ruß, guideline group*

Open access · greenAbstract readPractice Guideline
In one paragraph

Guideline in Deutsches Arzteblatt international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.4field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
  2. Article
  3. [Initial diagnosis and treatment of shock].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024
    Article
  4. Review
  5. Review
  6. Reply to the Letter to the Editor, regarding the article "German Cardiac Arrest Registry: rationale and design of G-CAR".Clinical research in cardiology : official journal of the German Cardiac Society · 2023
    Article
  7. German Cardiac Arrest Registry: rationale and design of G-CAR.Clinical research in cardiology : official journal of the German Cardiac Society · 2023
    Article
  8. Article
  9. Review
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Karl Werdan* Guideline group see eBox 1; Department of Internal Medicine III, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany; Department of Cardiology, Angiology and Internal Intensive Care Medicine, St. Marienkrankenhaus Siegen, Siegen, Germany; Department of Cardiology, Clinic Ottakring, Vienna Healthcare Group, Vienna, Austria; Department of Cardiology, University of Leipzig, Heart Center Leipzig, Leipzig, Germany; Department of Anesthesiology, University Hospital, LMU, Munich, Germany; Internists at the Maxplatz, Traunstein/Affiliate Cardiology Traunstein, Traunstein, Germany.
Michael Buerke
Alexander Geppert
Holger Thiele
Bernd Zwissler
Martin Ruß
guideline group*
Leipzig Heart Institute · DELudwig-Maximilians-Universität München · DEMartin Luther University Halle-Wittenberg · DEMedical University of Vienna · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe second edition of the German-Austrian S3 guideline contains updated evidence-based recommendations for the treatment of patients with infarction-related cardiogenic shock (ICS), whose mortality is several times higher than that of patients with a hemodynamically stable myocardial infarction (1).

methodsIn five consensus conferences, the experts developed 95 recommendations-including two statements-and seven algorithms with concrete instructions.

resultsRecanalization of the coronary vessel whose occlusion led to the infarction is crucial for the survival of patients with ICS. The recommended method of choice is primary percutaneous coronary intervention (pPCI) with the implantation of a drug-eluting stent (DES). If multiple coronary vessels are diseased, only the infarct artery (the "culprit lesion") should be stented at first. For cardiovascular pharmacotherapy-primarily with dobutamine and norepinephrine-the recommended hemodynamic target range for mean arterial blood pressure is 65-75 mmHg, with a cardiac index (CI) above 2.2 L/min/m2. For optimal treatment in intensive care, recommendations are given regarding the type of ventilation (invasive rather than non-invasive, lungprotective), nutrition (no nutritional intake in uncontrolled shock, no glutamine supplementation), thromboembolism prophylaxis (intravenous heparin rather than subcutaneous prophylaxis), und further topics. In case of pump failure, an intra-aortic balloon pump is not recommended; temporary mechanical support systems (Impella pumps, veno-arterial extracorporeal membrane oxygenation [VA-ECMO], and others) are hemodynamically more effective, but have not yet been convincingly shown to improve survival.

conclusionCombined cardiological and intensive-care treatment is crucial for the survival of patients with ICS. Coronary treatment for ICS seems to have little potential for further improvement, while intensive-care methods can still be optimized.

Indexed as

Drug-Eluting StentsMyocardial InfarctionAustriaHumansIntra-Aortic Balloon PumpingShock, Cardiogenic

Identifiers

PMID33827749
PMCPMC8192735
OpenAlexW3127021913

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.