Cardiogenic Shock

Cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusion.

Definition from clinical trials

SHOCK Trial

  • Clinical criteria:
    • SPB < 90 mmHg for ≥ 30 minutes
    • OR support to maintain SPB ≥ 90 mmHg
    • AND end-organ hypoperfusion (urine output < 30 mL/h or cold extremities)
  • Hemodynamic criteria:
    • Cardiac Index ≤ 2.2 L/min/m2
    • AND PCWP ≥ 15 mmHg

IABP-SHOCK II

Clinical criteria:

  • SBP 90 mm Hg
  • AND Clinical pulmonary congestion
  • AND Impaired end-organ perfusion (altered mental status, cold/clammy skin and extremities, urine output 2.0 mmol/L)

ESC HF Guidelines

  • SBP <90 mm Hg with adequate volume and clinical or laboratory signs of hypoperfusion
  • Clinical hypoperfusion: cold extremities, oliguria, mental confusion, dizziness, narrow pulse pressure
  • Laboratory hypoperfusion: metabolic acidosis, elevated serum lactate, elevated serum creatinine