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The management of cardiogenic shock remains one of the most challenging treatments in critical care. Although the survival rate has improved over the last decades, most patients suffering from this disease die of cardiac arrest and respiratory failure. With the increasing focus on the use of mechanical circulatory support, more efforts are being made to improve the survival rate. The most important intervention is the implantation of an assist device in a patient who is not responding to optimal medical treatment. While continuous flow centrifugal pumps have proved to be very successful in the postcardiotomy patient, implantation of left ventricular assist devices to provide temporary circulatory support in acute myocardial infarction is associated with a high failure rate. For these reasons, left ventricular assist devices are now being implanted during the perioperative period in patients suffering from cardiogenic shock after acute myocardial infarction. Percutaneous technologies such as left ventricular assist devices and intra-aortic balloon pumps have been shown to improve short-term survival in cardiogenic shock. Unfortunately, device-related complications, such as thrombosis and bleeding, and recurrence of cardiac arrhythmia remain frequent. Moreover, in patients who are not in cardiogenic shock but experience an acute coronary syndrome, percutaneous revascularisation has been shown to improve survival and reduce major complications. This review discusses the prognosis and management of cardiogenic shock and emerging percutaneous technologies.Dexamethasone influences the activity and expression of pro-apoptotic proteins in the ischaemic rat brain.
This study investigated the effect of dexamethasone in ischaemia induced brain damage. Focal cerebral ischaemia was induced by permanent occlusion of the right carotid artery and rats were treated systemically with dexamethasone 30 min before ischaemia induction. Immunohistochemical analyses showed that dexameth
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Additional file 1
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