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Advanced hemodynamic monitoring of the patient with acute heart failure and cardiogenic shock.

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Τίτλος: Advanced hemodynamic monitoring of the patient with acute heart failure and cardiogenic shock.
Συγγραφείς: Messina A; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089.; Department of Biomedical Sciences, Humanitas University, Via Levi Montalcini 4, Milano, Italy., Jozwiak M; Centre Hospitalier Universitaire l' Archet 1, 151 route Saint Antoine de Ginestière, 06200 Nice, France.; UR2CA, Equipe CARRES, Université Côte d ' Azur., Monnet X; AP-HP, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, DMU 4 CORREVE, Inserm U1358, IHU SEPSIS, CARMAS, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
Πηγή: Current opinion in critical care [Curr Opin Crit Care] 2026 Oct 01; Vol. 32 (5), pp. 564-572. Date of Electronic Publication: 2026 Sep 04.
Τύπος έκδοσης: Journal Article; Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9504454 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-7072 (Electronic) Linking ISSN: 10705295 NLM ISO Abbreviation: Curr Opin Crit Care Subsets: MEDLINE
Imprint Name(s): Publication: <1999->: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Philadelphia, PA : Current Science, c1995-
Ιατρικοί όροι (MeSH): Shock, Cardiogenic*/physiopathology , Shock, Cardiogenic*/diagnosis , Shock, Cardiogenic*/therapy , Heart Failure*/physiopathology , Heart Failure*/diagnosis , Heart Failure*/therapy , Hemodynamic Monitoring*/methods , Critical Care*/methods, Hemodynamics/physiology ; Monitoring, Physiologic/methods ; Humans ; Echocardiography ; Acute Disease ; Female ; Prognosis ; Male
Περίληψη: Purpose of Review: To provide a practical, physiology-driven framework for advanced hemodynamic monitoring in patients with acute heart failure (AHF) and cardiogenic shock, highlighting and supporting clinicians in integrating monitoring tools into an individualized bedside approach.
Recent Findings: Cardiogenic shock is increasingly recognized as a heterogeneous syndrome involving not only impaired cardiac output, but also systemic inflammation, vasoplegia, tissue hypoperfusion and multiorgan dysfunction. Recent studies have emphasized phenotype-based approaches for both diagnosis and treatment, integrating clinical evaluation, echocardiography, invasive hemodynamics and tissue perfusion markers. Machine learning derived phenotypes have further identified cardiorenal and cardiometabolic profiles associated with distinct prognostic implications. Critical care echocardiography has a central role for rapid diagnosis and serial reassessment, while transpulmonary thermodilution and pulmonary artery catheterization provide complementary information to echocardiography in refractory or complex cases.
Summary: Hemodynamic monitoring in AHF and cardiogenic shock should rely on individualized, multimodal and dynamic integration of clinical examination, biomarkers, echocardiography and invasive monitoring. The main goals are to define the underlying phenotype, assess congestion and tissue hypoperfusion, and evaluate treatment response. Echocardiography remains the cornerstone of bedside assessment, whereas invasive monitoring should be reserved for selected high-risk patients with persistent or complex shock.
(Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.)
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Contributed Indexing: Keywords: cardiogenic shock; hemodynamic monitoring; individualized therapy
Entry Date(s): Date Created: 20260905 Date Completed: 20260905 Latest Revision: 20260905
Update Code: 20260906
DOI: 10.1097/MCC.0000000000001420
PMID: 42700460
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1531-7072
DOI:10.1097/MCC.0000000000001420