CARDIOGENIC SHOCK - DR HANNAH SCHAUBROECK ( BELGIUM)

FOOD FOR THOUHT🤠🙋‍♂️🙋‍♀️
the treating team for the case in webinar gave fluids . can we give fluids and what are the indications in cardiogenic shock?
ANS 🤷‍♂️✔
Fluids can be given in CS if they are dry - n creps, no b lines, no echo or xray s/o fluid in lungs, typically such pts are around ~10% of all CS pts and are called cold and dry subset
Some examples of these patients are -- AMI with preceding vomiting, poor intake ( if presenting late) , AMI with parasympathetic stimulation in IWMI , RVMI, VIRAL MYOCARDITIS with h/o diarrhea , vomits, or CARDIAC ARREST who are revived but were dehydrated. Typically in lv dysfunction fluids can be given in dry pts if ef more than 30% and even in normal lv the first appearance of fluid in lungs is at pulmonary wedge pressure of 18 ,while n is 12 . Typically 250 ml is given slowly with monitoring
00:00:00 intro
00:01:47 definitions and concepts
00:04:48 scai classification
00:06:27 echo
00:06:59 etiology
00:10:11 shock teams
00:10;54 management
00:11:40 case
00:17:39 esc guidelines , evidence- norad . dobu, other ionovasopressors
00:24:00 case contd
00:24:45 revival of pa catheter?
00;25 :42 mechanical circulatory devices- iabp , impella, va ecmo
00:42:50 discussion

[@Haywire91]

Regarding ECMO in HF, does she mean incr LV work and LVEDP even after placing a LV vent?

[@youngindiaintensivist7709]

@parimal -she means va ecmo without a stent since stents are procedures not commonly done for va ecmo and their fn is to unload the lv , in fact iabp is more commonly used with va ecmo to decompress the lv