The Importance of Hemodynamic Profile in Cardiogenic Shock for Guiding the Appropriate Management

Abstract

Cardiogenic shock (CS)-a condition where cardiac damage resulting on hypotension and hypoperfusion of end organ-still have high mortality rate and becoming a reason for patients admitted to CICU. Diagnosis of CS can be made using clinical criteria such as unresponsiveness to fluid resuscitation or hypoperfusion of peripheral organ such as cold extremity. But sometimes, it’s difficult to distinguish shock caused by hypovolemia or low cardiac output/index (CI) without hemodynamic monitoring. Besides SCAI classification of CS, there is other classification that determined CS into four categories based on its hemodynamic type: dry warm (increasing of CI, low SVRI, low/normal PCWP), wet warm (low CI, low/normal SVRI, elevated PCWP), cold dry (low CI, high SVRI, low/normal PCWP), and cold wet (low CI, high SVRI, elevated PCWP). These approaches are important not only to established the diagnose but also to guiding the appropriate therapy.