The recent widespread availability and use of mechanical circulatory support (MCS) is transforming the management and outcomes of cardiogenic shock (CS). Clinical decision making regarding the optimization of therapies for patients with CS can be effectively guided by hemodynamic monitoring with a pulmonary artery catheter (PAC). However, since several studies regarding the benefit of PACs are ambiguous, the use of PACs is variable among clinicians treating patients with CS. More notable is that PAC use has not been studied as part of a randomized controlled trial in patients with CS with or without MCS. Standardized approaches to hemodynamic monitoring in these patients can improve decision making and better outcomes. In this review, we summarize the hemodynamics of CS and MCS with PAC derived measurements, and provide a compelling rationale for the use of PAC monitoring in patients with CS receiving MCS.
Tags: hemodynamics, Monitoring, PAC