Advanced haemodynamic monitoring in cardiogenic shock.

PURPOSE OF REVIEW: To describe haemodynamic monitoring methods that may be used in cardiogenic shock including the information they provide, their prognostic value, how they may be used for risk classification and guiding management.

RECENT FINDINGS: Haemodynamic monitoring in cardiogenic shock encompasses multimodal techniques that provide complementary information to enable identification of different cardiogenic shock phenotypes. Isolated right ventricular failure, biventricular dysfunction, and mixed cardiogenic shock are associated with poor outcomes and require different management strategies. Individual haemodynamic variables such as the velocity time integral at the left ventricular outflow tract, pulmonary artery pulsatility index, and cardiac power output are prognostically significant. Recent studies support the early use of pulmonary artery catheters to guide management.

SUMMARY: Cardiogenic shock remains a highly lethal condition. Haemodynamic monitoring enables phenotypic profiling and confers prognostic information. Combined strategies including pulmonary artery catheterization and advanced echocardiography help tailor management strategies. Ongoing trials will inform the timing and use of advanced haemodynamic monitoring tools to deliver individualized care.