Shock Management for Cardio-surgical Intensive Care Unit Patient: The Silver Days.

摘要: Shock in cardio-surgical intensive care unit (ICU) patients requires prompt identification of the underlying condition and timely therapeutic interventions. Management during first 6 hours, also referred to as "the golden hours", is paramount importance reverse shock state improve patient's outcome. The authors have previously described a state-of-the-art diagnostic work-up discussed how optimise preload, vascular tone, contractility, heart rate oxygen delivery this phase. Ideally, can be reversed initial period. However, some might developed multiple organ dysfunction, which persists beyond hours despite early haemodynamic treatment goals having been accomplished. This period, silver days", focus review. discuss reduce vasopressor load minimise adrenergic stress by using alternative inotropes, extracorporeal life-support short acting beta-blockers. review incorporates data on fluid weaning, safe ventilation, daily interruption sedation, delirium management rehabilitation. It includes practical recommendations areas where evidence scarce or controversial. Although cardio-surgery ICU patients, most considerations apply critical ill general.