The last decade has brought tremendous interest in the problem of cardiogenic shock. However, the mortality rate of this syndrome approaches 50%, and other than prompt myocardial revascularization, there have been no treatments proven to improve the survival of these patients. The bulk of studies have been in patients with acute myocardial infarction, and there is little evidence to guide the clinician in those patients with heart failure cardiogenic shock (HF-CS).

An International Society for Heart and Lung Transplant consensus conference was organized to better define, diagnose, and manage HF-CS. There were 54 participants (advanced heart failure and interventional cardiologists, cardiothoracic surgeons, critical care cardiologists, intensivists, pharmacists, and allied health professionals) with vast clinical and published experience in CS, representing 42 centers worldwide. This consensus report summarizes the results of a premeeting survey answered by participants and the breakout sessions where predefined clinical issues were discussed to achieve consensus in the absence of robust data.

Key issues discussed include systems for CS management, including the “hub-and-spoke” model vs a tier-based network, minimum levels of data to communicate when considering transfer, disciplines that should be involved in a “shock team,” goals for mechanical circulatory support device selection, and optimal flow on such devices.

Overall, the document provides expert consensus on some important issues facing practitioners managing HF-CS. It is hoped that this will clarify areas where consensus has been reached and stimulate future research and registries to provide insight regarding other crucial knowledge gaps.

过去十年引起了人们对心源性休克问题的极大兴趣。然而，这种综合征的死亡率接近50%，除了及时进行心肌血运重建之外，还没有任何治疗方法被证明可以提高这些患者的生存率。大部分研究都是针对急性心肌梗塞患者，几乎没有证据可以指导临床医生治疗心力衰竭心源性休克（HF-CS）患者。

组织了国际心肺移植学会共识会议，以更好地定义、诊断和管理 HF-CS。共有 54 名参与者（高级心力衰竭和介入心脏病专家、心胸外科医生、重症监护心脏病专家、重症监护医师、药剂师和专职医疗专业人员），代表全球 42 个中心，在 CS 领域拥有丰富的临床和发表经验。该共识报告总结了参与者回答的会前调查以及分组会议的结果，在分组会议中讨论了预定义的临床问题，以在缺乏可靠数据的情况下达成共识。

讨论的关键问题包括 CS 管理系统，包括“中心辐射”模型与基于分层的网络、考虑转移时通信的最低数据水平、“突击团队”应涉及的纪律、目标机械循环支持装置的选择以及此类装置的最佳流量。

总体而言，该文件就管理 HF-CS 的从业人员面临的一些重要问题提供了专家共识。希望这将澄清已达成共识的领域，并刺激未来的研究和登记，以提供有关其他关键知识差距的见解。