Therapeutic Dilemmas in Mixed Septic-Cardiogenic Shock Article

Full Text via DOI: 10.1016/j.amjmed.2022.09.022 Web of Science: 000898076100017

Cited authors

  • Jassir DU, Chaanine AH, Desai S, Rajapreyar I, Le Jemtel TH


  • Sepsis is an increasing cause of decompensation in patients with chronic heart failure with reduced or preserved ejection fraction. Sepsis and decompensated heart failure results in a mixed septic-cardiogenic shock that poses several therapeutic dilemmas: Rapid fluid resuscitation is the cornerstone of sepsis management, while loop diuretics are the main stay of decompensated heart failure treatment. Whether inotropic therapy with dobutamine or inodilators improves microvascular alterations remains unsettled in sepsis. When to resume loop diuretic therapy in patients with sepsis and decompensated heart failure is unclear. In the absence of relevant guidelines, we review vasopressor therapy, the timing and volume of fluid resuscitation, and the need for inotropic therapy in patients who, with sepsis and decompensated heart failure, present with a mixed septic-cardiogenic shock.

Publication date

  • 2022

Published in

International Standard Serial Number (ISSN)

  • 0002-9343

Number of pages

  • 6

Start page

  • 27

End page

  • 32


  • 136


  • 1