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Treatment options for cardiogenic shock due to left ventricular dysfunction

Treatment options for cardiogenic shock due to left ventricular dysfunction
General measures
Ventilation support to correct hypoxemia and, in part, acidosis
Optimize intravascular volume
Sodium bicarbonate only for severe metabolic acidosis (arterial pH less than 7.10 to 7.15)
Aspirin
Intravenous heparin
Possible glycoprotein IIb/IIIa inhibitor with NSTEMI
Insertion of pulmonary artery catheter
Specific measures
Pharmacologic support
Sympathomimetic inotropes (eg, dopamine)
Norepinephrine (for refractory hypotension)
Mechanical support
IABP, usually combined with percutaneous coronary intervention or coronary artery bypass graft surgery or possible thrombolytic therapy
Newer devices
Left ventricular or biventricular assist devices
Percutaneous cardiopulmonary bypass
Reperfusion/revascularization
Primary percutaneous coronary intervention
Coronary artery bypass graft
Thrombolytic therapy for patients not receiving PCI in a timely manner
Rx_options_cardiogenic_shoc.htm
Graphic 82406 Version 1.0

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