An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
Mortality for patients in cardiogenic shock is finally improving to be less than 50%. It had been hovering at 50% for decades. Would floating a Swan Ganz catheter, also known as a Pulmonary Artery Catheter improve outcomes in Cardiogenic Shock? The ESCAPE trial took the winds out of the sails of the Swan-Ganz enthusiasts in …
Continue reading Cardiogenic Shock & Swan-Ganz/Pulmonary Artery Catheters
In an effort to not fly blind in patients with advanced heart failure or cardiogenic shock, certain equations exist to help us manage our patients. This helps us identify who is not doing well and act on their deterioration before it really hits the fan. To measure how the left heart is doing, we use …
There are few options when it comes to right ventricular support for patients who are in right heart failure from a multitude of etiologies. At the time of this writing, we are limited to two temporary percutaneous right ventricular assist devices (RVAD) to assist our patients with this problem: the Impella RP and the Protek …
Continue reading Protek Duo Right Ventricular Assist Device (RVAD) ProtekDuo
Mortality in Cardiogenic shock, historically speaking, is around 50%. Everyone knows that we need to get better. An amazing push in sepsis management has significantly decreased the mortality of that pathology. The last decade has seen many advances towards improving mortality but without robust results, unfortunately. Inotropes and vasopressor have failed at saving lives. There …
Continue reading Impella vs. VA-ECMO for Cardiogenic Shock s/p Myocardial Infarction
