Cardiogenic shock is a complex syndrome defined by systemic hypoperfusion and inadequate cardiac output arising from a wide array of underlying causes. Although the understanding of cardiogenic shock epidemiology, specific subphenotypes, haemodynamics, and cardiogenic shock severity staging has evolved, few therapeutic interventions have shown survival benefit. Results from seminal randomised controlled trials support early revascularisation of the culprit vessel in infarct-related cardiogenic shock and provide evidence of improved survival with the use of temporary circulatory support in selected patients. However, numerous questions remain unanswered, including optimal pharmacotherapy regimens, the role of mechanical circulatory support devices, management of secondary organ dysfunction, and best supportive care. This Review summarises current definitions, pathophysiological principles, and management approaches in cardiogenic shock, and highlights key knowledge gaps to advance individualised shock therapy and the evidence-based ethical use of modern technology and resources in cardiogenic shock.

中文翻译：

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 心源性休克


心源性休克是一种复杂的综合征，定义为由多种潜在原因引起的全身性低灌注和心输出量不足。尽管对心源性休克流行病学、特定亚表型、血流动力学和心源性休克严重程度分期的理解已经发展，但很少有治疗干预措施显示出生存获益。开创性随机对照试验的结果支持梗死相关心源性休克中罪魁祸首血管的早期血运重建，并提供了在特定患者中使用临时循环支持可提高生存率的证据。然而，许多问题仍未得到解答，包括最佳药物治疗方案、机械循环支持装置的作用、继发性器官功能障碍的管理以及最佳支持治疗。本综述总结了心源性休克的当前定义、病理生理学原则和管理方法，并强调了推进个体化休克治疗的关键知识差距以及在心源性休克中对现代技术和资源的循证伦理使用。