Table 2.
Clinical criteria | Hemodynamic criteria | Cardiogenic shock adequately defined? | Cardiogenic shock achieved? | ||||
---|---|---|---|---|---|---|---|
Arterial hypotensiona | Pulmonary congestionb | End-organ hypoperfusionc | Low cardiac outputd | Elevated filling pressuree | |||
Dogs | |||||||
Sakamoto et al. | − | − | − | − | LAP > 10 mmHg | No | N/A |
Kawashima et al. | − | − | − | − | − | No | N/A |
Yu et al. | No predefined criteria | No | N/A | ||||
Ox | |||||||
Segesser et al. | “pressure drop” | − | − | − | − | No | N/A |
Pigs | |||||||
Møller-Helgestad et al. | − | − | SvO2 ≤ 35% | + | − | Yes | Yes |
Ostadal et al. | − | − | − | + | − | Yes | Yes |
Simonsen et al. | − | − | − | + | − | Yes | Yes |
Janak et al. | + | − | − | + | − | Yes | No |
Vanhuyse et al. | + | − | + | + | − | Yes | Yes |
Esposito et al. | No predefined criteria | No | N/A | ||||
Hala et al. | Cardiogenic shock not studied | N/A | |||||
Itoh et al. | No predefined criteria | No | N/A | ||||
Ostadal et al. | + | − | + | − | − | Yes | Yes |
Brehm et al. | + | − | − | − | + | Yes | No |
Kajimoto et al. | No predefined criteria | No | N/A | ||||
Zhu et al. | + | − | − | − | − | Yes | No |
Bartoli et al. | − | − | Reduction of SvO2 by 10% | + | Elevation of LAP ≥ 5 mmHg | Yes | Yes |
Sheep | |||||||
Sauren et al. | − | − | − | − | − | No | N/A |
Naito et al. | MAP reduction > 20 mmHg | − | − | + | LAP increase > 10 mmHg | Yes | Yes |
Data were divided into clinical and hemodynamic variables with “+” indicating the criterion was met and “−” indicating the criterion was not met. When a criterion was correctly defined but met a different threshold, we considered the criterion to be met and wrote the precise threshold used in the study. We considered that a study had defined cardiogenic shock adequately if (i) it was consistent with the guidelines in force at the time of the experiment; (ii) it used a combination of two criteria present in any guidelines including at least one clinical criterion; or (iii) it used one criterion in the context of acute heart failure induction. We considered that a study had achieved cardiogenic shock if those criteria were met during the experiment. Otherwise, it was considered as “acute heart failure without cardiogenic shock”.
LAP left atrial pressure; MAP mean arterial pressure; SvO2 venous saturation of oxygen
aSystolic blood pressure < 90 mmHg or inotrope, mean arterial pressure (MAP) < 65 mmHg, or > 20% drop in MAP. Based on criteria from SHOCK and IABP-SHOCK II Trial and NICE Clinical Guidelines
bCriteria from IABP-SHOCK II trial
cAltered mental status, cold/clammy skin and extremities, urine output < 0.5 mL/kg/h, pH < 7.35, elevated serum creatinine, lactate > 2.0 mmol/L. SvO2 threshold based on criteria from SHOCK and IABP-SHOCK II Trial, NICE, and ESC Clinical Guidelines
dCardiac index (CI) ≤ 2.2 L/min/m2 or cardiac output (CO) < 3.5 L/min or > 20% drop in CO. Based on criteria from SHOCK and IABP-SHOCK II Trials and ESC Clinical Guidelines
ePulmonary capillary wedge pressure (PCWP) ≥ 15 mmHg or increased left atrial pressure (LAP). Based on criteria from SHOCK Trial and ESC Clinical Guidelines