Cardiogenic shock

Cardiogenic shock continues to affect 5 per cent of all cases of acute myocardial infarction despite use of thrombolysis. The oxygen transport patterns have now been well defined. There is a reduction in CI to 2.2 l/min/m2 or below, and Vo2 is maintained at a normal levels by increases in OER and reductions in Sf^02. If an increase in CI can be achieved using inotropic agents, there are no increases in Vo2 and significant reductions in OER with increases in Sf^O^ Also, a small but significant number of patients present with the clinical picture of cardiogenic shock but with normal oxygen transport variables. This is an important subgroup as they make a full recovery without any further treatment except basic life support.

Similar oxygen transport patterns have been demonstrated following tension pneumothorax and massive pulmonary embolism.

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