Role of Circulatory Support in Cardiogenic Shock in France in 2018: Literature Review and Perspectives

Abstract

Cardiogenic shock remains an ill-defined entity, which is frequent in clinical practice (60,000–70,000 cases/year in Europe), with a poor prognosis and a mortality rate often exceeding 40% at 30 days. Through this review, we will try to define this clinical entity and its etiologies before discussing its incidence and prognosis. The physiopathological approach of cardiogenic shock will allow us to approach therapeutic management (volemia management, inotrops and vasoconstrictors, and ventilation) and its limits. Therefore, we will discuss about circulatory and cardio-circulatory supports available in France, in order to consider them within a global strategy of patient management. We will also discuss about their indications and the importance of the implantation timing in order to optimize their effectiveness. Finally, we will discuss about the assistance currently being developed but also the new therapeutic strategies that could happen in the upcoming years.