Zusammenfassung
Der infarktbedingte kardiogene Schock – meist die Folge eines linksventrikulären Pumpversagens – hat mit einer Sterblichkeit von 50-80% weiterhin eine schlechte Prognose. Therapieentscheidend ist die möglichst frühzeitige Wiedereröffnung des verschlossenen Koronargefäßes. Die Schockbehandlung beinhaltet die medikamentöse Herz-Kreislauf-Therapie mit Dobutamin als Inotropikum und Noradrenalin als Vasopressor der Wahl, gesteuert anhand einer Kombination von Druck- und Flussparametern, z. B. einem mittleren Blutdruck von 65-75 mmHg und einem Herzindex >2,51/min/m2. Die bestmögliche Therapie des kardiogenen Schocks beinhaltet zudem die intensivrnedizinischen Maßnahmen zur Vermeidung bzw. Behandlung des Multiorgandysfunktionssyndroms.
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Ruß, M., Buerke, M., Werdan, K. (2013). Therapie des infarktbedingten kardiogenen Schocks. In: Dirks, B., Somasundaram, R., Waydhas, C., Zeymer, U. (eds) Weiterbildung Notfallmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40720-8_5
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