GuidelineDeutsches Arzteblatt international2021
Infarction-Related Cardiogenic Shock- Diagnosis, Monitoring and Therapy–A German-Austrian S3 Guideline.
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.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Higher hospital volume is associated with lower mortality for patients with cardiogenic shock and mechanical circulatory support.European journal of heart failure · 2025Article
- Emergency Ultrasound in the Context of Cardiac Arrest and Circulatory Shock: "How to Avoid Cardiac Arrest".Life (Basel, Switzerland) · 2025Article
- [Initial diagnosis and treatment of shock].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Article
- [Monitoring of emergency cardiovascular patients in the emergency department : Consensus paper of the DGK, DGINA and DGIIN].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2023Review
- State of Shock: Contemporary Vasopressor and Inotrope Use in Cardiogenic Shock.Journal of the American Heart Association · 2023Review
- 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 · 2023Article
- German Cardiac Arrest Registry: rationale and design of G-CAR.Clinical research in cardiology : official journal of the German Cardiac Society · 2023Article
- Article
- Levosimendan in intensive care and emergency medicine: literature update and expert recommendations for optimal efficacy and safety.Journal of anesthesia, analgesia and critical care · 2022Review
- A Comprehensive Review of Mechanical Circulatory Support Devices.Heart international · 2022Review
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
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.
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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.